Remote Clinical IT SME - Community Care

GovCIO

Carson City (NV)

Remote

USD 110,000 - 130,000

Full time

4 days ago

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Benefits offered by this job

EAP

Corporate Discounts

Learning & Development platform

Training, Education and Certification

Referral Bonus Program

Internal Mobility Program

Pet Insurance

Flexible Work Environment

Job summary

GovCIO is seeking a Clinical Subject Matter Expert to serve as the clinical authority for community care health IT capabilities. The role focuses on documenting current-state processes, translating them into build-ready artifacts, and validating functionality with clinical user acceptance testing.

The position requires RN licensure, 5+ years of clinical healthcare experience, and remote work within the United States.

Qualifications

Bachelor's degree with 8+ years of experience or (commensurate experience).
Registered Nurse with 5+ years of clinical healthcare experience (or commensurate experience).
Active, unrestricted Registered Nurse license in a United States state or territory.
Two or more years of direct, hands-on work in VA community care referral coordination, consult management, community care scheduling, or community care eligibility and authorization. This experience must be current or within the last twelve months.
Daily working use of the VA referral management system (HSRM) and of VistA/CPRS, or of Millennium/PowerChart Referral Management at a Federal Electronic Health Record site.
Working knowledge of the Consult Toolbox, standardized episodes of care (SEOCs), and the Request for Services process.
Applied working knowledge of VHA Directives 1230, 1231, and 1232 and the Community Care Field Guidebook as they govern day-to-day consult and referral practice, and of community care eligibility standards under the MISSION Act.
Demonstrated ability to write clearly for an audience outside your own discipline, evidenced by work products such as procedures, job aids, training material, standard work, or briefing documents.
Ability to work remotely with reliable connectivity during core Eastern Time business hours.
Clearance Required: Ability to obtain and maintain a favorably adjudicated VA Public Trust background investigation.

Responsibilities

Serves as the clinical and operational authority for community care referral and care coordination workflows on a health IT delivery team.
Documents current-state clinical and administrative processes, converts them into user stories, acceptance criteria, business rules, and process diagrams that a technical team can implement, and validates delivered functionality through clinical user acceptance testing.
Ensures system behavior reflects governing VHA policy and field standard operating procedures.
Acts as the translator between frontline clinical practice, program leadership, and engineering.
Generally reports to a Program Manager.
Documents community care workflows end to end, including consult receipt and team assignment, eligibility verification and authorization, standardized episode of care (SEOC) selection, administrative screening and clinical triage, care coordination planning, referral and medical documentation exchange with community providers, appointment scheduling and follow-up, and episode of care closeout.
Surfaces the operational reality behind written procedures, including manual workarounds, undocumented service levels, and work performed outside the system today.
Translates clinical and operational knowledge into build-ready artifacts, including user stories, acceptance criteria, business rules, decision tables, and process diagrams.
Ensures system behavior reflects governing policy, including VHA Directives 1230, 1231, and 1232, the field standard operating procedures beneath them, consult status and action rules, cancellation and resubmission limits, contact-attempt requirements, and community care wait-time and drive-time eligibility standards.
Participates in requirements refinement, design reviews, and sprint demonstrations as the clinical reviewer, and identifies decisions that would not hold up under a real coordinator workload.
Defines and executes clinical user acceptance testing using scenarios drawn from actual case types, and determines whether delivered functionality is fit for field use.
Defines reporting and dashboard requirements from the coordinator and supervisor point of view, including the clinical definitions behind each metric.
Convenes and translates for a broader subject matter expert group covering adjacent functions such as scheduling, eligibility and authorization, and provider data, so that requirements are not limited to a single vista point.
Supports training and field readiness by identifying what staff need in order to use delivered functionality effectively.
Serves as the bridge between clinical intent and the data and analytics team so that metrics and reporting rest on correct clinical definitions.