Registered Nurse-Patient Aligned Care Team (Care manager)

Summary

The Miami VA Healthcare System's Nursing Service is seeking an experienced and dynamic Registered Nurse-Patient Aligned Care Team Manager. Ideal applicants are those who want to contribute to the achievement of quality care standards, as well as the growth and development of a VA academic hospital program.

Learn more about this agency This job is open to

The public U. S. Citizens, Nationals or those who owe allegiance to the U. S. Federal employees - Competitive service Current federal employees whose agencies follow the U. S. Office of Personnel Management's hiring rules and pay scales. Federal employees - Excepted service Current federal employees whose agencies have their own hiring rules, pay scales and evaluation criteria. Internal to an agency Current federal employees of the hiring agency that posted the job announcement. Veterans Veterans of the U. S. Armed Forces or a spouse, widow, widower or parent of a veteran, who may be eligible for derived preference Clarification from the agency

All qualified candidates encouraged to apply. Open to U. S. Citizens. NOTE: The 2-page Resume requirement does not apply to this position. For more information, refer to Required Documents below. Duties

This position is Part Time/Intermittent

The Patient Aligned Care Team (PACT) Registered Nurse Care Manager (RNCM): Outpatient Primary Care (PC) is responsible and accountable for all elements of the nursing process when providing nursing care and care coordination within the Primary Care PACT. The PACT RNCM assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction while functioning as a key team member providing comprehensive, coordinated nursing care to panels of patients.

Duties include but are not limited to

Provides fundamental primary care coordination for the PACT, supporting transitions of care, collaborating in Veteran-centered nursing care. Delivering preventive and chronic disease management interventions, and providing fundamental care through multiple modalities, including face-to-face visits, virtual encounters, secure messaging, and telephone-based services. Awareness of population health tools and knowledge of evidence-based guidelines to identify and manage high-risk and chronically ill patients.

Serves on the interdisciplinary team, applies structured appointment grids, and engages in proactive panel management to optimize health outcomes, support self management, and reduce avoidable complications Demonstrates leadership in delivering proactive, patient-centered care by using nursing knowledge, evidence-based guidelines, and standardized nursing protocols within the immediate practice setting. Acts as the primary coordinator for a designated panel of patients, emphasizing health promotion, chronic care management, patient self-management support, and overall wellness. Collaborate with the PACT team members, extended care support team, and external services to develop and implement holistic, patient-driven care, facilitate care transitions, and ensure timely, coordinated access to health care resources.

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:am-4:30pm (Note: Work schedules are determined and approved by the supervisor. The incumbent may be required to work various shifts on a permanent or temporary basis based on facility/patient care needs). Requirements

Conditions of employment

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. 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.

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/13031099.

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

Minimum of 3 years direct bedside patient care experience in a Medical/Surgical unit or equivalent. Outpatient/Ambulatory/Care Coordinator experience. Minimum BSN.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

Physical

Requirements

Must pass a pre-employment physical examination as required by VA Handbook 5019. This examination is administered by VA Occupational Health. This position requires moderate lifting up to 44 lbs., carrying objects up to 15 lbs., frequent reaching above shoulder, use of fingers, hands and legs, use of cranes and motor vehicles, walking & standing up to 8 hours, bending and climbing and able to hear whisper. The incumbent must be physically, emotionally and mentally stable in order to efficiently perform the essential functions of this position without hazard to themselves or others.

Additional information

This job…