[Hiring] Clinical Subject Matter Expert @Govcio

Role Description

GovCIO is currently hiring for a Clinical Subject Matter Expert to serve as the clinical authority on a team that designs and delivers health IT capabilities for Veteran community care. This role documents how community care works day-to-day, translates it into clear, testable requirements our technical team can build to, and validates that what we deliver holds up under a real clinic workload. This position is fully remote within the United States.

• 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
  • 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
  • Field standard operating procedures
  • Consult status and action rules
  • Cancellation and resubmission limits
  • Contact-attempt requirements
  • 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.
• 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.

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 (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
• Demonstrated ability to write clearly for an audience outside your own discipline
• 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

Preferred Skills and Experience

• Bachelor of Science in Nursing, or a graduate degree in nursing, health informatics, healthcare administration, or public health
• Experience contributing to system design, requirements definition, user story writing, user acceptance testing, or agile ceremonies
• Experience across more than one community care function, for example coordination plus scheduling, or coordination plus eligibility and authorization
• Experience working in more than one VA electronic health record environment
• Experience with community care reporting and dashboards, for example EPRS, VSSC, Power BI, Tableau, or CDW-sourced reporting
• Experience as a super user, preceptor, trainer, or site champion during a system rollout or upgrade
• Nursing informatics certification (for example ANCC Informatics Nursing), Certified Scrum Product Owner or ScrumMaster, SAFe, Lean or Six Sigma, or Project Management Professional (none of these is required)
• Prior experience supporting a federal health program as a contractor
• Existing VA Public Trust adjudication, which may shorten onboarding

Posted Salary Range

USD $110,000.00 - USD $130,000.00 /Yr.