Nurse; PACT Outpatient

Job Title

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*** Recruitment or Relocation incentive authorized for eligible, highly qualified candidates!
*** Duties include but are not limited to:

• Collaborates with the PACT members, extended care support team, and external services to develop and implement holistic, patient-driven care, facilitate care transitions, and ensure timely, coordinated access to health care resources.
• Engages in patient and family education and advocates for patients' needs to enhance patient outcomes and wellness.
• Delivers fundamental chronic disease management, preventive health services, patient education, and health coaching to support Veteran-centered goals.
• Collaborates in the coordination of same-day needs and post-discharge transitions by completing procedures, labs, follow-up, pre-visit preparation, clinical reminders, and referrals; works to connect Veterans with appropriate services, specialty care, and interdisciplinary team resources.
• Participates in daily huddles and collaborates with others to manage patients requiring RN care; provides individualized care, health coaching and motivational interviewing, and ongoing management for patients with chronic and ambulatory care-sensitive conditions.
• Connects patients with wraparound services; participates in the coordination of care to provide smooth transitions between acute and ambulatory settings for patients with chronic disease, population health, post-discharge, or acute needs.
• Delivers ongoing, fundamental RN-led chronic disease management using Veterans Affairs/Department of Defense (VA/DOD) clinical practice guidelines, evidence-based guidelines, health coaching, and collaboration with extended team members to support patient self-management, goal setting, and improved clinical outcomes.
• Communicates and treats customers (patients, visitors, volunteers, and all Medical Center staff) in a courteous, tactful, and respectful manner. Provides the customers with consistent information according to established policies and procedures.
• Handles conflict and problems in dealing with the customer constructively and appropriately.
• Assesses data reflective of the patient's status and interpret the information needed to identify each patient's requirements relative to their age- specific needs and to provide care needed as described in the services' policies and procedures.
• Identifies and manages patients requiring RN care through daily huddles and team collaboration; individualized care, health coaching and motivational interviewing, and delivers ongoing management for patients with chronic and ambulatory care sensitive conditions.
• Monitors team metrics and uses VHA panel management tools to identify care gaps, prepare patient data, and support proactive, high-quality primary care delivery.

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:

8:00am - 4:30pm, Monday through Friday with occasional evenings and weekends to accommodate extended hours.

Compressed/Flexible:
Not Authorized

Telework:
Not Available

Virtual:
This is not a virtual position.

Relocation/Recruitment

Incentives:

Not Authorized

Permanent Change of Station (PCS):
Not Authorized