PACT RN Care Manager: Primary Care & Care Coordination

Diversity Group; Fargo (ND); On-site; USD 65,000 - 90,000; Full time

Job summary

VA Midwest Health Care Network seeks a dedicated Registered Nurse (RN) Care Manager for the Patient Aligned Care Team (PACT) in a clinic setting. You will lead care coordination for an assigned patient panel, focusing on high-risk patients and smooth care transitions while collaborating with multidisciplinary teams.

You will utilize nursing expertise and evidence-based guidelines to develop patient-centered care plans, educate patients and families, and support self-management and wellness

Qualifications

• RN licensure that is active and unrestricted.
• BSN preferred or bridge program eligibility may be acceptable.
• Experience in primary care or outpatient clinics is advantageous.

Responsibilities

• Serve as primary care management contact for an assigned patient panel—focus on high-risk patients.
• Coordinate care transitions and population health strategies using data resources.
• Provide health education, coaching, and counseling to patients and families to support self-management.

Skills

Care coordination

Communication

Interdisciplinary teamwork

Evidence-based practice

Patient education

Education

RN licensure (active)

BSN preferred

Tools

VA Video Connect

EHR access

Job description

VA Midwest Health Care Network seeks a dedicated Registered Nurse (RN) Care Manager for the Patient Aligned Care Team (PACT) in a clinic setting. You will lead care coordination for an assigned patient panel, focusing on high-risk patients and smooth care transitions while collaborating with multidisciplinary teams.

You will utilize nursing expertise and evidence-based guidelines to develop patient-centered care plans, educate patients and families, and support self-management and wellness