Summary
Join the VA Black Hills Health Care System in Rapid City, South Dakota, as a Patient Aligned Care Team Registered Nurse Care Manager. Coordinate proactive, Veteran-centered primary care for a designated patient panel, support chronic disease management and care transitions, provide health coaching and education, and collaborate across disciplines to improve access, continuity, wellness, and long-term health outcomes across in-person and virtual care settings.
Duties
Make a meaningful impact on Veterans' health as a Patient Aligned Care Team Registered Nurse Care Manager in Rapid City. In this collaborative primary care role, you will help Veterans navigate their care, manage chronic conditions, achieve personal health goals, and successfully transition between care settings. Working closely with core and extended team members, you will use evidence-based practices, population health tools, education, and health coaching to identify needs early and connect Veterans with the right resources. This position offers the opportunity to build lasting relationships with Veterans while advancing coordinated, proactive care that improves access, continuity, wellness, and clinical outcomes. Duties include, but are not limited to: Coordinate comprehensive primary care for a designated panel of Veterans, supporting continuity, timely access, and individualized health goals. Deliver preventive and chronic disease management through face-to-face visits, virtual encounters, secure messaging, and telephone-based care. Identify rising-risk, high-risk, and chronically ill Veterans using population health tools and data-driven indicators to support proactive care management. Facilitate safe, coordinated transitions between acute and ambulatory settings, including post-discharge follow-up and connection to needed services. Provide individualized health coaching, motivational interviewing, patient education, and self-management support to help Veterans improve and maintain their health. Collaborate with core and extended care team members through daily huddles, pre-visit planning, and ongoing communication to address patient needs and care gaps. Coordinate same-day care needs, procedures, laboratory services, referrals, clinical reminders, and specialty care connections to promote efficient, patient-ready visits. Apply evidence-based clinical guidelines and nursing protocols to support chronic disease management, goal setting, wellness, and improved clinical outcomes. 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 7:30am - 4:00pm Telework: Ad hoc may be authorized. (Employees who telework on an occasional, episodic, or short-term, and have completed required telework training and telework agreement). Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being.
Requirements
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 evaluation. 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.
How you will be evaluated
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. 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.