The Community Care (CC) Coordinator Registered Nurse (RN) is responsible for executing a streamlined approach to receiving, triaging, and directing timely, coordinated care. This position is with Care in the Community (CITC) in Martinsburg, WV.
Major Duties include but not limited to: Demonstrates proficient practice and decision-making, deliberate planning, and critical thinking skills. Possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care regulations, and Veterans Health Administration (VHA) standards and guidelines.
Uses nursing knowledge and systems theory to assess, organize, facilitate, and guide Veterans through their full range of care options including internal/direct care in Veterans Affairs (VA) and care in the community. Serves as a liaison to both internal and community providers and is responsible for managing the care of the Veteran throughout the consult process.
Supports the medical center's mission to improve timely access to care, ensure Veterans who want to receive care in the community are referred and scheduled into the community, and support the delivery of high quality, timely care to the Veteran receiving community services.
Works collaboratively within the Office of Integrated Veteran Care (IVC) to triage Request for Services (RFS) to coordinate care processes defined by the IVC Field Guidebook to include developing a care coordination plan, reviewing medical documentation from community providers, communication of care coordination needs, and supporting the Veteran through the completion of the episode of care.
Influence care outcomes by collaborating with members of the interdisciplinary team both within the Veterans Affairs (VA) and in the community. Complies with VA-mandated processes and use of health information solutions that serve to assess, document, exchange, and track care coordination information.
Utilize delegation of authority, if applicable, to function at their highest level of role performance and align high-quality care with key performance indicators to ensure practice standards meet patient care needs. Supports colleagues and other nurses through knowledge sharing to provide safe, quality nursing care. Fosters a safe and supportive environment conducive to the professional development of health care professionals.
Evaluates outcomes of evidence-based decisions and practice changes for individuals, groups, and populations. Responsible for the documented outcomes at the program or service level. Program or service level outcomes must be broad and complex and can be demonstrated at any organizational level within a facility.
Provides oversight and care coordination for Veterans with community care consults, RCT consults, Hospital Notification EOCs, Community Programs consults, and Home Health consults.
VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential for performance awards Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure: 1 full and unrestricted license from any US State or territory Work Schedule: Monday - Friday, Day Shift Telework: Ad-Hoc Only.
Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized. Permanent Change of Station (PCS): Not Authorized.
Ashley.Warren@va.gov · 443-447-7635
This position is with Veterans Health Administration, Department of Veterans Affairs.
The posted pay range is $70938 – $135855/yr.
This position is eligible for telework.
Applications close on 2026-11-03.
This position is open under the 'Public' hiring path.
Source: USAJOBS.gov — U.S. Federal Government · Retrieved 2026-10-31 · Not affiliated with or endorsed by OPM or USAJOBS.gov
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