PACT Nurse Care Manager — Lead Care Coordination

LeadingAge Virginia; West Virginia; On-site; USD 70,000 - 100,000; Full time

Job summary

LeadingAge Virginia is seeking a Patient Aligned Care Team (PACT) Registered Nurse Care Manager (RNCM) to oversee nursing care and care coordination for a patient panel in a primary care setting.

The RNCM will educate patients on self-management, coordinate transitions of care, and collaborate with interdisciplinary teams to improve access and outcomes. A valid nursing license and English proficiency are required.

Qualifications

• Graduate of an approved nursing program with current US licensure.
• Ability to obtain State license and practice in nursing within VA systems.
• Understanding of patient education, self-management, and care coordination.

Responsibilities

• Coordinate and manage care for an assigned patient panel.
• Lead chronic disease management, preventive care, and health promotion.
• Identify high-risk patients using population health tools and plan interventions.
• Coordinate transitions of care and ensure timely access to services.
• Educate patients and families and support self-management.

Skills

English proficiency

Nursing license

Leadership

Education

Nursing degree (ADN/ Diploma or BSN)

State licensure

Bridge program opportunity (MSN/BSN pathway)

Job description

LeadingAge Virginia is seeking a Patient Aligned Care Team (PACT) Registered Nurse Care Manager (RNCM) to oversee nursing care and care coordination for a patient panel in a primary care setting.

The RNCM will educate patients on self-management, coordinate transitions of care, and collaborate with interdisciplinary teams to improve access and outcomes. A valid nursing license and English proficiency are required.