Registered Nurse-Patient Aligned Care Team (Care manager

Part Time/Intermittent Registered Nurse Care Manager (RNCM) Outpatient Primary Care (PC)

The Patient Aligned Care Team (PACT) Registered Nurse Care Manager (RNCM):
Outpatient Primary Care (PC) is responsible and accountable for all elements of the nursing process when providing nursing care and care coordination within the Primary Care PACT. The PACT RNCM assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction while functioning as a key team member providing comprehensive, coordinated nursing care to panels of patients.

Duties include but are not limited to:

• Provides fundamental primary care coordination for the PACT, supporting transitions of care, collaborating in Veteran-centered nursing care.
• Delivering preventive and chronic disease management interventions, and providing fundamental care through multiple modalities, including face-to-face visits, virtual encounters, secure messaging, and telephone-based services.
• Awareness of population health tools and knowledge of evidence-based guidelines to identify and manage high-risk and chronically ill patients.
• Serves on the interdisciplinary team, applies structured appointment grids, and engages in proactive panel management to optimize health outcomes, support self management, and reduce avoidable complications
• Demonstrates leadership in delivering proactive, patient-centered care by using nursing knowledge, evidence-based guidelines, and standardized nursing protocols within the immediate practice setting.
• Acts as the primary coordinator for a designated panel of patients, emphasizing health promotion, chronic care management, patient self-management support, and overall wellness.
• Collaborate with the PACT team 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.

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:am-4:30pm (

Note:

Work schedules are determined and approved by the supervisor. The incumbent may be required to work various shifts on a permanent or temporary basis based on facility/patient care needs).