The Transition and Care Management (TCM) and Polytrauma Nurse Case Manager practices as a Registered Nurse under the guidance of the TCM/Polytrauma Program Manager within Montana VA Health Care System and supports the mission and vision of the Healthcare System. This program provides clinical case management for severely injured and/or ill post 9/11 service members and other service members with identified case management needs. The TCM Case Manager is responsible for acquiring and demonstrating clinical expertise and knowledge of health care programs to improve the quality of patient care, the use of resources, and to facilitate compliance with internal and external requirements and standards; acquiring and demonstrating strength in the areas of interpersonal relations, critical thinking, problem solving, and conflict resolution; collaborating with other case managers, the Interdisciplinary Care Management Review Team (IDCMRT) and other clinical and administrative staff as need to ensure patient care needs are met. The incumbent begins the case management process prior to admission to the facility and works collaboratively with staff from other Veterans Health Administration (VHA) facilities, Military Treatment Facilities, and various referring facilities. The TCM/Polytrauma Case Manager completes an in-depth assessment of functional status acuity level, prognosis, and assesses the need for treatment services and resources. The TCM/Polytrauma Case Manager initiates contact with the patient and/or family to assist and ensure the transition to the VHA is safe and continuous. The incumbent monitors patient status while the patient is receiving care at the facility. The TCM/Polytrauma Case Manager communicates and coordinates with the IDCMRT to develop a biopsychosocial Comprehensive Plan (CP) of care for post 9/11 inpatients and outpatients. When determined by the IDCMRT, the TCM/Polytrauma Case Manager may serve as the Lead Coordinator. The TCM/Polytrauma Case Manager documents appropriately in within the patient record, Care Management Tracking and Referral Application (CMTRA) and the Interagency Comprehensive Plan (ICP). The incumbent, in collaboration with the IDCMRT, is responsible for coordinating performance improvement initiatives and for collecting relevant data required for Commission on Accreditation of Rehabilitation Facilities (CARF) certification and Joint Commission on the Accreditation of Healthcare Organizations (JC) standards. Work Schedule: 8:00 am to 4:30 pm, Monday - Friday (May be negotiable after selection, but must be full-time) Financial Disclosure Report: Not required Telework may be authorized for highly qualified applicants.
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.