Nurse, Healthcare Nursing

Registered Nurse Care Manager

Help The PACT Registered Nurse Care Manager (RNCM) functions as a core member of the Primary Care Patient Aligned Care Team (PACT), providing comprehensive, evidence-based nursing care and care coordination for an assigned panel of Veterans. The RNCM delivers proactive, Veteran-centered care focused on chronic disease management, preventive health, care transitions, self-management support, and improved patient outcomes.

Responsibilities include:

• Serving as the primary care coordinator for an assigned panel of Veterans within the Marion Primary Care PACT.
• Performing assessment, planning, implementation, and evaluation using the full nursing process to improve clinical outcomes.
• Providing RN-led chronic disease management and preventive health services using established VA/DoD guidelines and evidence-based practice.
• Managing care transitions across inpatient, outpatient, specialty, community, and virtual settings to ensure continuity of care.
• Identifying high-risk and rising-risk Veterans using population health tools; executing focused panel management to close care gaps.
• Conducting health coaching, motivational interviewing, and patient education to support self-management and Whole Health goals.
• Coordinating same-day access needs, post-discharge follow-up, labs, clinical reminders, procedures, and specialty referrals.
• Participating in daily PACT huddles and collaborating with the interdisciplinary team to improve access, continuity, quality, and Veteran experience.
• Reviewing team metrics, preparing patient data, and supporting proactive approaches to care delivery.
• Maintaining professional communication and customer service, advocating for Veterans and supporting positive patient outcomes.
• Engaging in continuous professional development, mentoring, precepting, and integration of evidence-based practice.

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-Friday. This position may require flexibility based on clinical need.

Telework: ad-hoc

Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: not authorized

Permanent Change of Station (PCS): not authorized