Registered Nurse - PACT

Veterans Health Administration, Department of Veterans Affairs; Kenosha (WI); On-site; USD 90,000 - 120,000; Full time

Job summary

The PACT RNCM serves as the primary coordinator for a patient panel emphasizing health promotion, chronic care management, patient self-management support, and overall wellness within the Veterans Health Administration system.

This role requires RN licensure, nursing education, and strong English proficiency, with duties spanning care coordination, transitions, and interdisciplinary collaboration in a primary care setting.

Qualifications

• Graduate of a nursing program approved by the appropriate accrediting body and licensed in the US.
• State license as a professional nurse and ongoing licensure requirements.
• Foreign nursing education requires equivalency validation where applicable.

Responsibilities

• Care Coordination & Transition Management: oversee primary care coordination for PACT, manage transitions, and deliver chronic disease management.
• Patient Care/Customer Service: coordinate same-day needs, labs, referrals, and post-discharge activities.
• Team collaboration: work with PACT core team to improve access, continuity, and quality outcomes.

Skills

Primary Care experience

Care coordination

RN experience

Education

RN degree / nursing program

Job description

Summary

The PACT RNCM acts as the primary coordinator for a designated panel of patients emphasizing health promotion - chronic care management - patient self-management support - and overall wellness.

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
• Preferred Experience: 3 years of Primary Care experience 3 years of RN experience 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/13093593
• 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 *related field with a BSN and 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 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 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/
• 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 assigned patients - Utilization of safe patient handling and mobility protocols

Duties

• Care Coordination & Transition Management: Provides expertise in 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
• Patient Care/Customer Service: Coordinates same day needs and post discharge transitions by managing procedures - labs - follow-up - pre-visit preparation - clinical reminders - and referrals
• ensures Veterans are connected with appropriate services - specialty care - and interdisciplinary team resources
• Population Identification: Leads initiatives to improve data driven outcomes by using data-driven risk indicators to identify rising- and high-risk patients - prioritize focused panel management - and coordinate appropriate referrals for enhanced care management sharing best practices/improvements beyond the immediate practice setting
• Stratification - Care Coordination & Transition Management: Uses nursing expertise to identify gaps in care and connect patients with wraparound services
• coordinates care and ensures smooth transitions between acute and ambulatory settings for patients with chronic disease - population health - post discharge or acute needs
• Leads process improvement or quality improvement initiatives to improve processes or patient outcomes beyond the immediate practice setting
• Team Support and Teamwork: Collaborates with PACT core team members and the extended care support team to reach PACT goals related to access - continuity - patient experience and quality outcomes through huddles - pre-planning - and daily communication to support access - continuity - quality - and patient experience while facilitating efficient - patient-ready visits
• 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
• 8:00 a.m
• - 4:30 p.m
• Telework: Not Available Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized