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Registered Nurse (rn) Care Manager Patient Aligned Care Team Pact Job in SALT LAKE CITY, UT

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Registered Nurse (rn) Care Manager Patient Aligned Care Team Pact Job in SALT LAKE CITY, UT

Registered Nurse (rn) Care Manager Patient Aligned Care Team Pact Job in SALT LAKE CITY, UT

Vacancy No. CASC-10113412-18-KMS Department Veterans Affairs, Veterans Health Administration
Salary $50,505.00 to $98,005.00 Grade 00 to 00
Perm/Temp Permanent FT/PT Full-time
Open Date 1/11/2018 Close Date 1/22/2018
Who may apply Public

Job Description (Please follow all instructions carefully)


  • Open & closing dates

    01/11/2018 to 01/22/2018

  • Salary

    $50,505 to $98,005 per year

  • Pay scale & grade

    VN 00

  • Work schedule


  • Appointment type



1 vacancy in the following location:

Relocation expenses reimbursed


Announcement number


Control number


  • Duties



    OUR MISSION: To fulfill President Lincoln's promise - "To care for him who shall have borne the battle and for his widow, and his orphan" - by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate care to Veterans?

    The VA Salt Lake City Health Care System (VASLCHCS) is made up of compassionate employees committed to caring for Veterans whose sacrifices know no limit. We are part of the Rocky Mountain Veterans Integrated Service Network (VISN 19). Our health care system consists of the George E. Whalen Utah, Idaho, and Nevada. We provide health care to over 50,000 eligible Veterans across one of the largest geographical areas in VA. We are a teaching hospital, providing full range of patient care services, holistic medicine as well as education and research in partnership with the University of Utah and other institutions of higher education. Comprehensive health care is provided through our primary care providers and tertiary care is offered in areas of medicine, surgery, psychiatry, physical medicine and rehabilitation, neurology, oncology, dentistry, and geriatrics.

    Learn more about this agency


    The Patient Aligned Care Team (PACT) RN Care Manager (RNCM) is a licensed professional RN who is assigned to a designated panel of patients within Primary Care. The PACT RNCM works in partnership with other team members, which includes the patient, to effectively and efficiently deliver and manage preventative, proactive, patient-driven care and chronic disease management and care needs. The RNCM demonstrates leadership in delivering efficient, comprehensive, and continuous patient-driven holistic care through active patient care, collaboration, communication, and coordination of resources.

    The RNCM actively collaborates with the PACT team members (patient, provider, Medical Support Assistant (MSA), and LPN) and larger Team (family/caregiver, internal and community-based services) in supporting the patient centered, patient-driven holistic plan of care. The RN Care Manager uses the nursing process and evidence-based practice to provide proactive, preventative and patient-driven care. As a member of the patient-aligned care team (PACT), the RN Care Manager is responsible for collaborating with services internal and external to the VA to facilitate and coordinate care transition in order to effectively and safely meet the patients' needs. The RNCM provides patient and family health education with a focus on self-management, prevention, and wellness, based on the patient's goals. The RNCM serves as an advocate for patients and actively engages with his/her team and colleagues as she/he continues to enhance his/her own and the team's professional growth, development and practice. Duties include but not limited to:

    • Demonstrates advanced clinical knowledge in assessing, planning, implementing, documenting, and evaluating care for a panel of patients across the continuum of care, recognizing the age related cognitive, physical, emotional, and chronological maturation needs of the adult and geriatric patient.
    • Participates in chronic disease management for panel in collaboration with provider. Engages in Shared Medical Appointments (SMA), and/or RNCM visits.
    • Utilizes the Primary Care Almanac and PACT Metrics to address population health management issues and improve Team processes.
    • Triages and applies a collaborative team approach in identifying, analyzing, and resolving patient care problems.
    • Assists in determining appropriate scheduling based on patient's clinical need. Right person, right place, right time
    • Collaborates with ancillary team members and resources within the clinic to manage clinic access issues. This may include assisting other nursing staff with maintaining clinic flow.
    • Promotes patient, family and team interactions, and problem solving by actively participating in interdisciplinary meetings to facilitate coordination and the achievement of identified goals.
    • Retains current knowledge of multidisciplinary resources, programs, and services, referring patients for community resources as appropriate. Demonstrates ability to collaborate and coordinate with all levels of services and disciplines.
    • Collaborate with patients to assess and identify needs, issues, care goals, and resources for achieving desired outcomes post hospital recovery and health maintenance/wellness by effectively using Motivational Interviewing and TEACH techniques.
    • Supports patient self-management by providing an ongoing relationship with the PACT with current information regarding all options, choices, and resources. Provides patient centered care while respecting patient's personal values, cultural, and belief system.
    • Utilizes approved Protocols and Guidelines to facilitate autonomy in providing care. Works at the top of scope of practice.
    • Accurately documents coordination and care provided in CPRS.
    • Manages patient care alerts in CPRS in a timely, safe and effective manner.
    • Serves as a resource for patient and family rights, responsibilities, and decision-making information and processes.
    • Actively participates in reviewing and updating policies, procedures, and standards to promote evidence-based, patient-driven care.
    • Maintains professional knowledge and skills based on current evidence-based practice. Maintains expertise in chronic care/disease management and Health Promotion/Disease Prevention.
    • Maintains effective working relationships with professionals and support personnel within the medical center and the community.
    • Applies critical thinking and analytical skills to identify barriers for optimal patient care delivery and utilizes processes improvement strategies to correct or improve current state.
    • Utilizes creativity and innovation. Recommends and participates in interdisciplinary opportunities to improve patient care or clinical efficiency.
    • As needed, provides back-up coverage for other team members and other PACT RNCM within the clinic.

    Work Schedule: Monday through Friday, Day Shift
    Financial Disclosure Report: Not Required

    Travel Required

    Not required

    Supervisory status


    Promotion Potential


    Who May Apply

    This job is open to…

    US Citizens and Status Candidates

    Questions? This job is open to 2 groups.

  • Requirements
  • Required Documents
  • Benefits
  • How to Apply
  • Fair & Transparent

Note: We cannot accept applications on behalf of Federal Agencies. Application instructions are listed within the Job Description.

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