General Description of Assigned Duties: Delivers fundamental knowledge-based care to assigned clients while developing technical skills. Assesses, plans, implements, and evaluates care based on age-specific components. Evaluates care and outcomes to ensure timely and appropriate provision of services. Assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care.
Focus is on individual growth and development in practice with increased levels of self-direction. This nurse brings principles and theory with limited application of critical thinking skills. Provides patient management, care coordination, and discharge/disposition planning for inpatient and outpatient settings.
The Transplant Care Coordinator assists Veterans, family members, and caregivers with receiving the most appropriate transplant options and services to meet their complex health care needs.
Coordinates timely processing of pre/post transplantation patients care coordination requirements, to include repetitive record review to assure that ongoing monitoring and timely submission of transplant consideration packets into Veterans Affairs Central Office (VACO) Tracer Program, travel, and imaging/pathology. Demonstrates cognitive decision-making, communication, and counseling to address the patients' needs.
Continued monitoring of proper medication management, treatment plans, and team goals. Coordinates care with multiple providers across all levels and sites of care. Coordination includes assuring services interface within the Veterans Affairs (VA) and CNH programs to provide continuity of care to patients. Utilizes databases to provide population management to track patient care through all episodes of care.
Responsible for providing continuous patient education about transplantation status and future needs/requirements for successful transplantation. The CNH Registered Nurse assists Veterans, family members, and caregivers with receiving the most appropriate options and services to meet their complex health care needs.
This includes, but is not limited to, acute, chronic, multiple, complex, catastrophic, or life-threatening illnesses; combat stress, residuals of traumatic brain injury; community adjustment; addictions and other health problems.
The CNH Registered Nurse performs clinical nursing review of medical records of patients who are hospitalized in non-VA hospitals to determine point of stability for payment purposes and potential for transfer of the Veteran to a VA facility for care. Possesses knowledge of utilization management processes, clinical documentation requirements, current standards of care, and compliance guidelines.
Maximizes third-party payments for care and delivering quality patient care performance improvement activities. The CNH Registered Nurse develops and coordinates seamless transitioning of patients throughout the inpatient and outpatient care process with a focus on discharge planning needs. Reviews and assists in patient referrals to CNH facilities to ensure continuity of qualified comprehensive care.
Participates as needed in the discharge planning assessment and implementation of community health services, to include skilled nursing care, hospice, adult day health services, respite services and activities required to successful transition the patient to the appropriate non-acute care setting. Performs follow-up and oversight visits to the Veteran after admission to the CNH to ensure that adequate and safe care is being provided while under VA contract.
Advocates for holistic care through patient/family education and provider interaction and implements an educational plan to meet the patient care needs.
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 8:00am.
- 4:30pm. Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized
shanika.glover@va.gov · 314-358-0100
This position is with Veterans Health Administration, Department of Veterans Affairs.
The posted pay range is $64088 – $117134/yr.
Applications close on 2026-09-14.
This position is open under the 'Fed Internal Search' hiring path.
Source: USAJOBS.gov — U.S. Federal Government
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