PACT Registered Nurse Care Manager Outpatient

Veterans Health Administration, Department of Veterans Affairs; Wichita Falls (TX); On-site; USD 84,000 - 110,000; Full time

Job summary

The Veterans Health Administration, Department of Veterans Affairs is seeking a Registered Nurse Care Manager for the Patient Aligned Care Team in Outpatient Primary Care. The RNCM coordinates care, supports transitions, and delivers Veteran-centered nursing care within the PACT.

Responsibilities include leading patient education, collaborations with the PACT team, and applying evidence-based nursing protocols to improve outcomes.

Qualifications

• English language proficiency required
• Graduate of a school of professional nursing approved by ACEN or CCNE
• Current, full, active, and unrestricted registered nursing license in a US state/territory or DC
• Ability to obtain state licensure through bridge program where applicable
• Nurse I/II/III level progression criteria and leadership expectations (per VA qualification standards)
• Experience with care coordination and patient education is valued

Responsibilities

• Provides primary care coordination for the Patient Aligned Care Team (PACT).
• Oversees transitions of care and delivers preventive and chronic disease management.
• Collaborates with PACT and extended care teams to ensure timely, coordinated access to care resources.
• Engages in patient and family education to enhance outcomes and wellness.
• Leads a collaborative approach to manage patient panels and ensure continuity of care.

Job description

Summary

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.

Qualifications

Basic Requirements:

• English Language Proficiency
• In accordance with 38 U.S.C. 7403(f) - no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English
• Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE)
• OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program
• Upon achievement of a State license - the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program
• (Reference VA Handbook 5005 - Appendix G6)
• OR In cases of graduates of foreign schools of professional nursing - possession of a current - full - active - and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program
• Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD)
• Current - full - active - and unrestricted registration as a graduate professional nurse in a State - Territory or Commonwealth (i.e. - Puerto Rico) of the United States - or the District of Columbia
• Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements - but do not possess the required licensure - may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification
• Grade Determinations: The following Scope - Education and Dimension criteria must be met in determining the grade assignment of candidates - and if appropriate - the level within a grade
• The Dimension requirements (Practice - Veteran/Patient Driven Care - Leadership - Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/13087275
• Grade/Level Scope Education Nurse I - Level I Delivers fundamental - knowledge-based care to assigned clients while developing technical competencies
• An Associate Degree (ADN) or Diploma in Nursing - with no additional professional nursing required
• Nurse I - Level II Demonstrates integration of biopsychosocial concepts - cognitive skills and technically competent practice in providing care to clients with basic or complex
• An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I - Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required
• Nurse I - Level III Demonstrates proficiency in practice based on conscious and deliberate planning
• Self-directed in goal setting for managing complex client situations
• An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I - Level 2
• OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I - Level 2
• OR a Master's degree in nursing (MSN) and no additional professional nursing experience
• OR a Master's degree in a *related field with a BSN and no additional professional nursing experience
• Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• A BSN with 2 years of professional nursing equivalent to Nurse I - Level 3
• OR an MSN with one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Doctoral degree in Nursing with no professional nursing experience
• OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience
• Nurse III Executes position responsibilities that demonstrate leadership - experience and creative approaches to management of complex client care beyond the immediate practice setting
• MSN and 2 years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Master's degree in *related field with BSN and two years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• *Note: Foreign education programs/degrees are not creditable as related degrees
• Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/
• Preferred Experience: 2-years general nursing experience Physical Requirements: This position includes a level of physicality normally associated with duties performed by nurses such as direct patient care - and potentially long periods of walking - standing - sitting - moderate lifting - repeated bending - or kneeling
• Examples may include but are not limited to: - Significant amounts of time standing assisting patients - Utilization of safe patient handling and mobility protocols
• Applicants must be able to safely operate a government vehicle to conduct home visits with Veterans.

Duties

• Major Duties include - but are not limited to: Provides primary care coordination for the Patient Aligned Care Team (PACT) - overseeing transitions of care - developing and implementing Veteran-centered nursing care - delivering preventive and chronic disease management interventions - and providing care through multiple modalities - including face-to-face visits - virtual encounters - secure messaging - and telephone-based services
• 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
• 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
• Engages in patient and family education and advocates for patients' needs to enhance patient outcomes and wellness
• Champions a collaborative team approach for managing patient panels - ensuring continuity and quality of care tailored to individual patient goals and needs
• This position potentially requires flexibility in schedule and assignments
• All other duties as assigned
• 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 - 0800-1630 Telework: Not Available Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized