Registered Nurse-Outpatient Primary Care

Summary

The Patient Aligned Care Team (PACT) Registered Nurse (RN) Care Manager will utilize the nursing process, evidence-based practice, and metrics to deliver and manage comprehensive care to an assigned panel of patients in a clinic setting. The RN is a key member of the PACT and multidisciplinary team and is responsible for collaboration with other team members, promoting effective communication and ethical practice while integrating population health to meet the needs of the Veteran.

Duties

• Duties include but are not limited to: The RN PACT Care Manager is responsible for providing competent, evidence-based care to assigned patients. Provides patient management, care coordination, and discharge planning for inpatient and outpatient settings, assisting Veterans, family members, and caregivers in accessing appropriate services for complex health care needs. The RN PACT care Manager coordinates care across multiple providers and settings, ensuring continuity of care within VA and community programs. Integrates nursing protocols in daily practice to work to the top of education and competency Applies clinical knowledge/judgment to lead staff involvement in planning, decision-making, and evaluating outcomes within the immediate practice setting Effectively functions as a leader, with demonstrated outcomes, for the immediate practice setting Improves Veteran/patient driven care by resolving experience issues such as coordination of care, timeliness or process issues, common themes of dissatisfaction, or environment of care concerns for the immediate practice setting Serves as a resource and advocate for patients, families, and caregivers, improving outcomes for the immediate practice setting Demonstrates the ability to improve the effectiveness of communications and interactions with others, to inspire their cooperation and confidence to ensure safe and effective outcomes in the current practice setting Leads teams, contributes to team huddles, and actively collaborates in all phases of patient care planning; reviews team metrics and assist team in developing a plan to improve patient outcomes Integrates population health into daily practice with RN nurse visits, using patient-centered needs and goals, assessment, and metrics while using motivational interviewing to improve Veteran wellness and outcomes Complete two-day discharge calls, coordinate discharge follow-up from the hospital, Emergency Department (ED), or other setting Provide patient and family health education with a focus on self-management, shared decision making, and prevention and wellness that is based on the individual patient's goals Recognizes and triages urgent or emergent patient care situations and initiates appropriate emergency interventions as directed Participates in team performance improvement and sustainment activities to optimize team efficiency and care delivery to patients Perform virtual care modality visits (VVC, CVT) 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- 0700-1530 or 0800-1630 Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized

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/13034984. 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. Preferred Experience: BSN preferred Basic Life Support (BLS) required Minimum two years RN varied medical/surgical/critical care/Emergency Department clinical experience required Mastery of computer skills to include electronic medical records, Microsoft Office applications, Microsoft Teams meetings, and prior experience doing virtual patient visits Preferred previous Ambulatory Care and/or community-based experience working with chronic disease management Demonstrated excellent critical thinking and multi-tasking skills Demonstrated strong patient/care giver teaching skills Demonstrates strong organizational skills and problem-solving abilities Previous experience in case management preferred Excellent interpersonal communication skills Team player who is proactive to change Creativity, flexibility, and the ability to work in fast-paced changing environment Past experience triaging patients Monitoring data for quality improvement and improved patient outcomes Prior experience with performance/quality improvement projects 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 advance practice nurses such as physical assessment, and potentially long periods of walking, standing, sitting, moderate lifting, repeated bending , or kneeling

Requirements

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Must pass pre-employment physical evaluation/examination. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). You may be required to serve a probationary period. Complete all application requirements detailed in the "Required Documents" section of this announcement.

How to apply

All applicants are encouraged to apply online. To apply for this position, you must complete the full questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 09/18/2026 to receive consideration. To preview the questionnaire, click https://apply.usastaffing.gov/ViewQuestionnaire/13034984. To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire. Click Submit My Answers to submit your application package. NOTE: It is your responsibility to ensure your responses and appropriate documentation are submitted prior to the closing date. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions.