The Incumbent is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care. Administers medications and procedures per established policies and guidelines. Influences care outcomes by collaborating with members of the interdisciplinary team.
Major Duties: Uses the nursing process and evidence-based practice to collaborate with the Teamlet and larger Team to meet patient care needs. Provides patient and family health education with a focus on self-management, prevention, wellness, and Whole Health, based on the patient's goals. Demonstrates advanced clinical knowledge in assessing planning, implementing, documenting, and evaluating care for a designated group of patients.
Educates patients regarding clinic procedures and what to expect during the procedure. Assists with clinic procedures and monitors patient for any adverse effect. Triages and applies a collaborative team approach in identifying, analyzing, and resolving patient care problems; documents own interventions. Monitors progress using clinical standing orders, analyzes variations, and initiates appropriate actions.
Maintains current knowledge of multidisciplinary resources, programs, and services. Refers patients for community resources as deemed necessary. Reviews options with patients and families, alternatives, risks/benefits, and services. Educates the patient and family on disease processes, resources, plan of care, treatments, and /or procedures.
Screens patients for social service, home care, and other community care needs; and coordinates or makes referrals as appropriate; and seeks consultation when indicated. Ensures the patient's provider is aware of patient progress, issues, and/or problems.
Evaluates needs and facilitates the patient's ability to learn the principles of self-care; utilizes appropriate resources if the patient is unable to grasp the knowledge/skills needed for self-care through the use of motivational interviewing. Utilizes approved Standing Orders and Guidelines to facilitate autonomy in providing care. Promotes cost effective use of resources and effective strategies including nonface-to-face approaches (including telehealth).
Maintains privacy and confidentiality of all patient information, including electronic, print, and conversations. Applies skills, such as motivational interviewing to promote patient self-management. Adheres to policies, procedures, and standards to promote evidence-based patient driven care. Timely compliance of required web-based educational modules (Talent Management System TMS). Completes and documents secure messaging within 72 hours. Surrogate is always identified.
Escalation of secure messaging must be maintained at 10% or less. Routes messages to appropriate care lines as needed. Performs other tasks as requested by providers or supervising nursing personnel within the scope of training and abilities. Demonstrates flexibility and adapts to work demands or adjustment of assignments.
Performs as a role model in the provision of excellent customer service Reviews Message Manager and assists Team to address/complete pending alerts communicated throughout tour of duty to facilitate care and address needs of the caller within 48 hours or before being cognizant of the Veteran awaiting response Completes and documents Nursing Notes in CPRS, as applicable, in a timely manner and closes the Encounter Notes for patients not seen by a provider.
Notes will be closed by the end of tour of duty daily. Areas to be addressed include: Encounters: reasons for visit- Service Connection; Primary Assignment-Service connected conditions under the Diagnosis tab; Procedures, ACSC conditions, etc.
Provides Care Management to patients with Ambulatory Care Sensitive Conditions (ACSCs) including review of the patient record, deciding if the patient needs more indepth education (formal and/or informal), nursing visits, and/or telephone calls between provider visits to assist in care management. Collaborates with the High-Risk Care Coordinators, Home Telehealth, social work, and/or dieticians for referrals and care management.
Cultivates an environment of professionalism, excellence, and conflict resolutionat the team level. Promotes teamwork and is a resource for support staff, peers, and other clinical staff. Cleans equipment per RME policy after each use. Major Duties Continued Under Education.
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, 8:00am-4:30pm Telework: Adhoc Eligible Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized
The Associate Degree Nursing (ADN), Bachelor of Science degree in Nursing (BSN), or Master of Science degree in Nursing (MSN) must be fully accredited by the Accreditation Commission for Education in Nursing (ACEN) or the Commission On Collegiate Nursing Education (CCNE).
Verification of accreditation may be obtained from http://www.acenursing.us/accreditedprograms/programsearch.htm or https://directory.ccnecommunity.org/reports/accprog.asp If your school has changed names, or is no longer in existence, you must provide this information in your application.
If your school was accredited by ACEN or CCNE at the time of graduation, but is no longer listed on the websites, you must provide documentation of accreditation with your application packet. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education.
For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html. IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.
Major Duties Continued from Duty Section: Fosters health promotion and risk reduction strategies for patients through the assessment and utilization of the SAIL performance measures, ACSC conditions, HEDIS performance measures, utilization of the Specialty Productivity Report and Quadrant Tool (SPARQ), EQm, DataMart, and EPRP data. Provides patient care in collaboration with the interdisciplinary team, patients, and caregivers.
Serves as a clinical resource expert and functions as an educator for the team and patient. Supports patient-driven care in a safe, efficient manner, using evidence-based principles. Adheres to and promotes High Reliability Organization principles and values. Participates in daily huddles addressing new processes, safety concerns, updates on equipment and supplies, current projects focused on improvement, and daily announcements.
Actively participates and engages in the electronic huddle tool (Visual Management System VMS). Performs daily review of charts in preparation for scheduled patient appointments. Ensures results are available for the provider and obtains medical records, when applicable. Confirms appointment modality is suitable for the patient, including performing VA Video Connect testing if needed. Utilizes warm handoff communication for care-coordination to other levels of care.
Provides patients with personalized, proactive, and patient-driven health care through such activities as assisting in developing a personal health plan, listening to the patient and addressing their needs/goals, engaging in group appointments, encouraging and supporting Telehealth modalities, and creating an environment that benefits the veteran.
This position is with Veterans Health Administration, Department of Veterans Affairs.
The posted pay range is $75849 – $158316/yr.
This position is eligible for telework.
Applications close on 2026-10-23.
This position is open under the 'Fed Competitive' hiring path.
Source: USAJOBS.gov — U.S. Federal Government · Retrieved 2026-10-16 · Not affiliated with or endorsed by OPM or USAJOBS.gov
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