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    Summary

    The RN Care Manager is directly responsible and accountable to the manager overseeing the clinic activities. This position has a full range of duties, utilizing the nursing process to provide direct/ indirect patient care for Cardiology. The Care Manager assures coordination of care for Cardiology patients at Redding, but also works with external facilities to coordinate/transition higher levels of cardiac care (DGMC, SFVA, UCD etc..).

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    Responsibilities

    The Cardiology Care Manager is a patient advocate utilizing all resources to achieve optimal patient outcomes in the hospital and cardiology clinics.

    • Has a close working relationship with Primary Care for smooth and timely coordination/transition of care.
    • Provides patient/family education as it related to the disease process, medication management, and side effects.
    • Enhances patient self-management by providing information regarding all options, choices and resources.
    • Promotes health promotion and risk reduction strategies.
    • Maintains and manages the Dashboard for compliance.
    • Collaborates with physicians and implements plan of care with a focus on performance measures and meeting goals.
    • Provides direct patient care and physician support, and serves to assure continuity of care. Manages Secure Messaging.
    • Works closely with the other specialty clinics to facilitate the accomplishment of any Cardiology procedures through timely coordination and verification of patient.
    • A leader in the core team, and responsible for collaborating with services, both internal and external to the VA to facilitate care.
    • Other duties as assigned by Nurse Manager and assistant nurse manager.
    Major duties include, but may not be limited to:
    • Collects assess data based on patient signs, symptoms and history and provides appropriate care (clinical assessment, communication with treating Provider)
    • Triage Consults, patient care needs as appropriate, pertinent clinical reminders
    • Provides health care education to patients/family members utilizing the nursing process
    • Develops a plan of care using information from the patient, family, and provider.
    • Bridge the gap between discharge and PCP follow-up care.
    • Identifies high risk patient population, transition to appropriate discipline (PC, HBPC, CCHT, Hospice/Palliative Care etc.)
    • Responsible for intensive monitoring, follow-up and clinical management of high-risk patients.
    • Completes work assignments within established time frames; adapts to changes in or additions to work assignments including cross covering other specialty clinics whenever necessary; reprioritizes as necessary. (Contingency Planning)
    • Maintains current licensure, BLS/ACLS, current training Rapid Response/ Emergency Mgt.
    • Completes mandatory training, updates, memo/minutes updates and annual training per policy.
    • Provides patient and family health education with a focus on self-management, prevention, and wellness, based on the patient's goals.
    • Coordinates Care (procedures, labs, teaching, patient visits and transitions in care)
    • Partners with other high-risk outpatient clinics (standardize care mgt. of high-risk patients)
    • Manage/Maintain Dashboard of High-Risk Patients and ensure appropriate care being given.
    • Medication adjustment and titration by protocol and standardized protocol by Provider
    • Identify available community resources (assure referrals made by service to external services resulting in timely appointments, ensuring safe and effective transitions)
    • Telephone visits, CHF RN appointments with oversight from Provider, manage walk-in patient concerns, telephone demands from patients.
    • Serves in a role to support Telehealth clinical programs across the system.
    NOTE: THIS IS AN INTERMITTENT POSITION NOT TO EXCEED 1 YEAR
    BENEFITS MAY NOT BE THE SAME AS FOR A FULL-TIME POSITION. PLEASE SPEAK WITH HR FOR SPECIFIC QUESTIONS REGARDING BENEFITS AVAILABLE TO INTERMITTENT STAFF.
    Salary will be pro-rated based on actual hours worked.
    Work Schedule: Monday - Friday, 8 Hour Shifts, Variable
    Financial Discloser Report: Not required

    Travel Required

    Not required

    Supervisory status

    No

    Promotion Potential

    3

  • 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/550380200. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.