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    The Home Telehealth Registered Nurse Care Coordinator/Case Manager is a professional who coordinates care for a panel of patients throughout the continuum of care to assure that care is timely, appropriate, of high quality and cost effective. The RN Care Coordinator works closely with the primary care provider(s) and other healthcare professionals and team members, other clinics, internal or external services and community agencies.

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    • Provides professional assessment, coordination and planning of multiple healthcare services, acts on behalf of the Veteran to assure that necessary clinical services are received and that progress is being made.
    • Provides leadership in application of the nursing process and identifies resources and critical factors for achieving desired outcomes for discharge, post hospitalization recovery and health maintenance/improvement.
    • Provides initial and ongoing assessment of patients to identify needs issues, care goals and appropriate resources necessary for care management.
    • Sets clinical care goals, short and long term, in collaboration with patient, provider(s), and family members.
    • Provides care and counseling of persons or in the promotion and maintenance of health and prevention of illness and injury based upon the nursing process which includes systematic data gathering, assessment, appropriate nursing judgment, and evaluation of human responses .

    Work Schedule: Monday through Friday 8:00 a.m. to 4:45 p.m.
    Financial Discloser Report: Not required

    Travel Required

    Not required

    Supervisory status


    Promotion Potential


  • Job family (Series)

    0610 Nurse

This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/549194000. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.