Registered nurse - patient aligned care team care manager

Summary

This is an OPEN CONTINUOUS ANNOUNCEMENT. This announcement will remain open until the closing date or until filled. Applicants will be reviewed for eligibility and referred on a regular basis. Are you a self-directed, compassionate Registered Nurse (RN) looking to make a tangible difference? As a Patient Aligned Care Team (PACT) Care Manager at the VA, you'll provide comprehensive, coordinated care for primary care patients in an interdisciplinary, team-based environment.

Duties

The PACT Care Manager (RN) duties include, but are not limited to, the following:

• Functions as a team member providing comprehensive, coordinated nursing care to panels of patients with occasional supervision.
• Manages care coordination for a designated panel of patients, emphasizing health promotion, chronic care management, patient self-management support, and overall wellness.
• Collaborates with the PACT members, extended care support team, and external services to develop and implement holistic, patient-driven care, facilitate care transitions, and provide timely, coordinated access to health care resources.
• Engages in patient and family education and advocates for patients' needs to enhance patient outcomes and wellness.
• Oversees 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.
• Collaborates with interdisciplinary team members, applies structured appointment grids, and engages in proactive panel management to optimize health outcomes, support self-management, and reduce avoidable complications.

Preferred Experience

3 years clinical experience with 1 year experience in case management or similar role.

Work Schedule

This is an intermittent position. Intermittent employment is defined as non-fulltime employment in which employees are appointed without a regularly scheduled tour of duty. Work is sporadic and unpredictable so that a tour of duty may not be regularly scheduled in advance. Expected availability for this position is two, 8-hour shifts per biweekly pay period. Additional hours may be scheduled as needed. Shifts may be scheduled Monday-Friday, and between the hours of 7:30 am - 5:00 pm.

Telework

Not available.

Virtual

This is not a virtual position.

Relocation/Recruitment Incentives

Not authorized.

Permanent Change of Station (PCS)

Not authorized.

Additional Information

The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being.