Clarification from the agency

Current permanent employees of the Veterans Health Administration including permanent Veterans Canteen Service employees, current permanent full-time Hybrid Title 38 and permanent full-time Title 38 employees. Past/Current/Upcoming Graduates of VHA Health Trainee Programs (HPT) are eligible to apply (must send proof such as an SF-50 with application). NOTE: The 2-page Resume requirement does not apply to this position. For more information, refer to Required Documents below.

Videos

The Clinical Resource Hub (CRH) Tele-Nephrology Registered Nurse (RN) provides advanced clinical, technical, and programmatic support essential to sustaining high-quality virtual nephrology care across the Veterans Integrated Services Network (VISN). The Tele-Nephrology RN demonstrates leadership, independent clinical judgment, and innovative approaches to managing complex kidney-related conditions in a virtual environment.

Duties include but are not limited to:

• Supports all VISN 1 Hub locations for the enterprise-wide initiative that are involved in the delivery of virtual nephrology services, including VA medical centers, community-based outpatient clinics, and provider alternate worksites, ensuring seamless care across distributed environments.
• Manages incoming and outgoing VISN 1 CRH nephrology consults, ensuring timely review, appropriate triage, accurate assignment, and coordination of follow-up actions consistent with established national and VISN consult management standards.
• Provides enterprise-wide support to the VISN 1 CRH, delivering synchronous and asynchronous Tele-Nephrology services to Veterans within and outside the VISN when needed.
• Provides direct virtual patient care to one or more panels of nephrology patients, including those with chronic kidney disease (CKD), hypertension, fluid and electrolyte disorders, kidney transplant follow-up needs, and dialysis-related concerns.
• Conducts remote assessments using telehealth technologies, interprets home monitoring data (blood pressure, weight, symptoms), reviews lab values, identifies early signs of deterioration, and escalates findings consistent with clinical protocols.
• Coordinates laboratory scheduling, virtual visit workflows, consult and visit triage, care coordination, and longitudinal follow-up for nephrology patients receiving virtual care.
• Facilitates smooth transitions of care between Primary Care, Nephrology, dialysis providers, Pharmacy, Nutrition, Social Work, and other interdisciplinary team members, minimizing fragmentation and ensuring continuity across virtual and in-person services.
• Engages Veterans and caregivers in shared decision-making, providing tailored education on CKD self-management, blood pressure control, fluid and dietary management, medication adherence, and preparation for advanced kidney therapy options.
• Delivers telephone and video-based clinical triage, responding to patient concerns, reviewing symptoms, identifying urgent needs, and ensuring timely access to appropriate nephrology or acute care services.
• Provides comprehensive care management, ongoing monitoring, and coordination services, acting as an advocate for the Veteran to ensure timely receipt of recommended evaluations, treatments and follow-up care.
• Supports, trainings, and collaborates with CRH and spoke-site staff on Tele-Nephrology workflows, virtual care technologies, remote monitoring platforms, and best practices in virtual nephrology nursing.
• High-level clinical reasoning and decision-making skills, including the ability to identify early signs of clinical deterioration through virtual assessments, triage appropriately, and provide accurate, timely documentation within VA digital health systems (CPRS, JLV, RPM platforms, etc.).

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: Full-time, Monday-Friday, 8:00am - 4:30pm
Remote: This is a remote, exempted/mid-term extension position. Exempted/Mid-term extension positions are reviewed regularly and do not imply permanent remote status.
Virtual: This is not a virtual position.
Financial Disclosure Report: Not required.

Notifications:

• This position is not a Bargaining Unit position.
• Current and former Federal employees must submit copies of their most recent SF-50 (Notice of Personnel Action). The SF-50 must identify the position title, series, grade, step, tenure and type of service (Competitive or Excepted). In some cases, more than one SF-50 may be required to show a higher grade previously held.
• This position is in the Excepted Service.
• The salary is based on the grade and step approved for the selected candidate.

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.
• Must pass pre-employment physical examination.
• 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.

Preferred Experience:

• Experience providing comprehensive nephrology nursing care, including assessment and ongoing management of chronic kidney disease (CKD), acute kidney injury (AKI), electrolyte disorders, hypertension, and kidney-related complications across diverse Veteran populations.
• Advanced skill in remote clinical management of nephrology patients, including interpretation of home monitoring data (blood pressure logs, weight trends, symptom monitoring), review of laboratory trends, and timely escalation of care needs.
• Demonstrated proficiency in supporting Veterans using virtual care technologies, including remote patient monitoring (RPM) platforms, telehealth devices, secure messaging, and video visits-providing education, troubleshooting, and guidance for technology-enabled cared.
• Experience coordinating pre- and post-dialysis care across modalities (in-center hemodialysis, home hemodialysis, and peritoneal dialysis), including remote monitoring of dialysis-related parameters, patient education, and assessment for treatment-related complications.
• Familiarity with management of nephrology-specific therapies (e.g., anemia management, mineral bone disorder treatment, immunosuppressive medications) with the ability to review lab results, document assessments, and contribute to medication titration per protocol or provider guidance.
• Strong skills in Veteran and caregiver education, with the ability to deliver individualized teaching on CKD self-management, lifestyle modification, blood pressure control, fluid management, and adherence to complex treatment plans in a virtual environment.

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/12901562.

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.

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

Physical Requirements: Position is subject to a pre-employment physical and medical examination. This position requires: lifting, carrying; reaching above shoulder; use of fingers; walking (8 hours); standing (8 hours); repeated bending; working alone; protracted or irregular hours of work and occasional emotional strain.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

Résumé Reminder: Your résumé must include the following information each job listed:

1. Job title
2. Duties (be as detailed as possible)
3. Month & year/end dates (e.g. June 2007 to April 2008)
4. Full-time or part-time (include hours worked per week)
5. Education should be included (list school and conferred date)

NOTE: Candidate's education, scope, and length of nursing practice (experience) will be considered in determining the grade and salary of the applicant selected. The recommended salary may be at any point in the range listed for this vacancy.

Experience as an RN will be evaluated to determine if the experience is of an acceptable level of quality with regard to the following five dimensions of nursing: Practice, Veteran/Patient Driven Care, Leadership, Professional Development, and Evidence/Based Practice/Research. Each dimension of practice has criteria that demonstrate essential core competencies for VHA Nursing Personnel.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.

It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.

Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.