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Veterans Affairs, Veterans Health Administration

Martinez, California

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Registered Nurse (Home Based Primary Care)
The Home Based Primary Care RN Care Manager provides nursing assessment, care coordination, skilled nursing care, and chronic disease management in the homes of Veterans including private residences, residential care facilities, assisted living facilities in collaboration with the HBPC multidisciplinary team. The HBPC RN Care Manager assumes the following roles and responsibilities. 1. Provides direct nursing care by administering assessments, planning and implementing interventions, and monitoring outcomes. 2. Completes new admission assessments and maintains assigned panel of Veterans. 3. Documents patient care assessments, interventions, care coordination, quarterly reviews, and care plan outcomes in the electronic medical record. 4. Collaborates with RN colleagues for panel coverage d


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