Home Based Primary Care; HBPC - Registered Nurse; RN

Position: Home Based Primary Care (HBPC) - Registered Nurse (RN)
The HBPC Outpatient Staff RN delivers competent, evidence-based nursing care to Veterans enrolled in the HBPC Program. This role involves providing direct patient care and comprehensive care coordination for Veterans in their homes. The RN will conduct case management activities, assist Veterans in obtaining appropriate nursing resources, and ensure continuity of care across the healthcare continuum.

This position requires daily travel to Veterans' homes. All care is provided in a home setting.

The incumbent of this position must have a valid, state-issued driver's license.

The HBPC registered nurse, in addition to being a core member of the HBPC interdisciplinary team, functions in the PACT team role as a care manager and is responsible for:

* Delivering direct nursing care in the home setting.

* Developing and coordinating the patient's plan of care to include ongoing assessment and reassessment, care planning, care coordination, monitoring, and evaluating clinical outcomes.

* Interacting, coordinating and advocating for the patient/caregiver with other relevant parties across a continuum of care, beyond a single episode of care, ensuring seamless transitions.

* Providing individualized education and support to the patient and caregiver to optimize clinical outcomes and support quality of life decisions. Delegating and supervising the care given to the patient by licensed practical nurses (LPNs) or vocational nurses, and home health technicians, as applicable.

* Providing intensive care management.

* Linking Veterans with resources.

* Coordinating resources for comprehensive care to avoid duplication of services and streamline staff interaction and services with the Veteran. Participating in the development of the individual plan of care at interdisciplinary care meetings for assigned panel of patients.

In addition to the listed duties, the HBPC RN Care Manager uses patient information databases to identify at-risk Veterans requiring coordination of care, utilization of and participation of other team member's services, and use of decision support tools (along with critical thinking skills) to triage Veterans with symptom-related complaints.

Furthermore, the HBPC RN Care Manager monitors and tracks consults in collaboration with the HBPC team, assisting in ensuring the Veteran receives the right care, at the right time, in the right place.

VA offers a comprehensive total rewards package: VA Nurse Total Rewards

Pay:
Competitive salary, regular salary increases, potential for performance awards

Paid Time Off:
Up to 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:

Full-time; 730-1600

Telework:
Not Available

Virtual:
This is not a virtual position.

Relocation/Recruitment

Incentives:

Not Authorized

Permanent Change of Station (PCS):
Not Authorized