Registered Nurse - Patient Aligned Care Team

About the role

The Registered Nurse Care Manager (RNCM) is responsible for organizing and directing team members to achieve desirable patient outcomes through day-to-day and/or telephonic case management. The RNCM functions in the Primary Care Clinic which utilizes a Patient Aligned Care Team (PACT) model. The RNCM uses the nursing process and evidence-based practice to collaborate with the Core Team in developing the patient-driven care plan.

Responsibilities

• Demonstrates clinical knowledge in assessing, planning, implementing, documenting and evaluating care for a designated group of patients across the continuum of care.
• Triage and apply a collaborative team approach in identifying, analyzing and resolving patient care problems.
• Collaborates with patients to assess and identify needs, issues, care goals and resources in critical factors for achieving desired outcomes for discharge, post hospital recovery and health maintenance/wellness.
• Maintains current knowledge of multidisciplinary resources, programs and services, referring patients for community resources as appropriate.
• Utilizes problem-solving methodologies and advances clinical knowledge to resolve system and/or processes that impact patient care.
• Assists with navigation of health systems and intervenes or refers as needed to facilitate the achievement of patient outcomes.
• Provides care, respecting patient's personal values, cultural and belief systems.
• Affords assistance in the development, assessment, and monitoring/evaluation of comprehensive plans of care to ensure efficient, effective, and coordinated care in meeting and promoting standards of wellness.
• Coordinates an interdisciplinary approach to assure physical, psycho-social, and environmental needs and resource delivery to achieve patient goals.

Requirements

• Demonstrates clinical knowledge in assessing, planning, implementing, documenting and evaluating care for a designated group of patients across the continuum of care.
• Triage and apply a collaborative team approach in identifying, analyzing and resolving patient care problems.
• Maintains current knowledge of multidisciplinary resources, programs and services, referring patients for community resources as appropriate.
• Utilizes problem-solving methodologies and advances clinical knowledge to resolve system and/or processes that impact patient care.
• Assists with navigation of health systems and intervenes or refers as needed to facilitate the achievement of patient outcomes.
• Provides care, respecting patient's personal values, cultural and belief systems.
• Affords assistance in the development, assessment, and monitoring/evaluation of comprehensive plans of care to ensure efficient, effective, and coordinated care in meeting and promoting standards of wellness.
• Coordinates an interdisciplinary approach to assure physical, psycho-social, and environmental needs and resource delivery to achieve patient goals.

Qualifications

• Basic Requirements: English Language Proficiency, Graduate of a school of professional nursing approved by the appropriate accrediting agency, Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth of the United States, or the District of Columbia.
• Nurse I, Level I: An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required.
• Nurse I, Level II: 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: 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: 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: An 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.

Pay, Benefits & Schedule

• Competitive salary, regular salary increases, potential for performance awards
• 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
• 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)
• Work Schedule: Monday - Friday, 7:30am - 4:00pm
• Compressed/Flexible: Telework: Adhoc Only, At the discretion of the hiring manager
• 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, Graduate of a school of professional nursing approved by the appropriate accrediting agency, Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth of the United States, or the District of Columbia.
• Nurse I, Level I: An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required.
• Nurse I, Level II: 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: 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: 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: An 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.