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Health Promotion and Disease Prevention Disease Manager Registered Nurse (rn)

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$56,078.00 to $103,846.00

Big Spring, TX


Open & closing dates

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$56,078 to $103,846 per year

Pay scale & grade

VN 00

Work schedule


Appointment type



1 vacancy in the following location:

Big Spring, TX

Big Spring, TX

Relocation expenses reimbursed


This job is open to

The public

U.S. citizens, nationals or those who owe allegiance to the U.S.

Clarification from the agency

Open to US Citizens

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The incumbent will lead the development and execution of multidisciplinary disease management activities in collaboration with the Chief of Staff (COS), Associate Director, Patient Care Service (ADPCS), Health Promotion and Disease Prevention Program Manager (HPDP PM), RN Case Manager (CM), Safe Patient Handling/Patient Educator (SPH/Pt Ed), Group Practice Manager (GPM), Patient Aligned Care Teams (PACT) and others as needed in support of disease prevention and population health needs. Will monitor and provide support and education for medical screening efforts to identify at risk individuals and groups to ensure comprehensive health education, appropriate clinic preventive services, coaching for health behavior change, and support of self-management for chronic disease. Develops and evaluates an annual DM plan for inclusion in the HPDP strategic plan in collaboration with all stakeholders, (e.g. COS, ADPCS, HPDP PM, GPM, PACT). Uses available data sources (e.g. Strategic Analytics for Improvement and Learning (SAIL), VHA Support Service Center (VSSC)) to identify, assess, and prioritize the needs of targeted subsets of patients for specific DM needs. Uses data-driven processes to prospectively and retrospectively identify indicators of ineffective or inefficient delivery of care including, but not limited to, high-cost, high-volume, or problem-prone diagnoses, procedures, and services, and high utilization rates for services (e.g., pharmacy, Urgent/ Emergency Care, Ambulatory Care Sensitive Conditions (ACSC), and outpatient visits). Makes recommendations for cost containment or process improvements. Will develop and provide DM education/training for all clinicians to included, but not limited to; Disease Management, documentation of DM/preventive care in individual plan of care, current/projected resource utilization, community/ social support systems, health risk assessment, and chronic disease health goals, continuum of care, and Clinical Practice Guidelines (CPG). Actively assists/guides PACT or other service for CM coordination of care for complicated /complex high risk patients. Will lead the collaboration with patients, patient groups, and stakeholders on the implementation of DM services for chronic disease populations, in the formulation of patient-centered goals, and evidenced-based interventions.

Work Schedule: Monday-Friday 8:00am-4:30pm, but may require flexible shifts based on facility needs.

Financial Disclosure Report: Not required

Learn more about this agency


Will document DM-related care provided using the face-to-face, Clinical Video Telehealth (CVT), telephonic, or secure message (SM) interactions. Will Code encounters using International Classification of Diseases (ICD), Evaluation and Management (E&M), and DM-specific Healthcare Common Procedure Coding System (HCPCS) codes. Will complete and signed encounters within 72 hours. Will track and report to appropriate team/committee/individual DM-related data, process and outcome measures, identified opportunities for improvement, and status of DM process improvement projects/programs. Communicates and collaborates with other members of the healthcare team and others as needed to ensure continuity of patient care for chronic disease population/groups. Leads comprehensive multidisciplinary patient care planning meetings as part of the HPDP team. Ensures the comprehensive patient care plan includes, but is not limited to, objectives, goals, and actions designed to meet the assessed needs for healthcare, safety, attainment of agreed by the patient/family and the multidisciplinary care team of the patient's health goals and ensures agreement is documented in Computerized Patient Record System (CPRS). Will provide a warm handoff (person-to-person verbal communication providing continuity of care and a seamless transfer of information) of patients in transition to other levels or places of care by providing pertinent information to the receiving health care provider (e.g., patient self-management status); documents warm handoff in CPRS. Collaborates with RN Case Manager, HPDP PM and stakeholders (e.g. COS, ADPCS, HPDP PM, GPM, PACT) in the development of an annual Utilization Management (UM) plan for high cost, high volume, and high patient utilizers for inclusion into the HPDP strategic plan. As member of the HPDP team, will collaborate in the performance of UM data analysis using available data resources (e.g. VISTA, CPRS, ACSC, SAIL, VSSC) and reports data as needed or instructed. Will report negative trends and identify quality of care issues requiring immediate attention. Will participate as HPDP team member in the evaluation of clinical practice patterns and trends and provides feedback to clinical. Is a member of the Health Promotion and Disease Prevention (HPDP) Program Committee and actively participates in care coordination meetings/committees as assigned. Conducts DM peer reviews as indicated. Other duties as assigned

Travel Required

Not required

Supervisory status


Promotion Potential


Job family (Series)

0610 Nurse

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Conditions of Employment

You must be a U.S. Citizen to apply for this job

Designated and/or random drug testing required

Selective Service Registration is required for males born after 12/31/1959

You may be required to serve a probationary period

Subject to a background/security investigation

Must be proficient in written and spoken English


Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

Graduate of a school of professional nursing approved by the appropriate State-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

). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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.

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.

Preferred Experience: Bachelors degree or higher. Knowledge of health promotion and disease prevention. Basic computer skills with a knowledge of Electronic Medical Records. Demonstrate leadership in identifying and analyzing population health data. Understand and apply application based practice. Experience in strategic planning, program development, and implementation. Ability to interact and communicate across discipline/service lines. Ability to provide education in field of expertise and ability to take direction to build a program. Practice American Nursing Code of Ethics.

Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade: Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required.

Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience.

Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience.

Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required.

Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 year's of nursing practice/experience; OR a Doctoral degree.

Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office.

Physical Requirements: This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations or operative/invasive procedures. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs.


IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: ****. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: ****Additional information

Annual leave shall accrue for full-time Nurses, and Nurse Anesthetists at the rate of 8 hours for each full biweekly pay period.

Selected applicants will be required to complete an online onboarding process.

This job opportunity announcement may be used to fill additional vacancies.

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

This position is in the Excepted Service and does not confer competitive status.

United States Citizenship Required; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

VA encourages persons with disabilities to apply. The health related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority.

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.

If you are unable to apply online view the following link for information regarding an Alternate Application

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, résumé, 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 and length of nursing practice (experience) will be considered by a Nurse Professional Standards Board 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 four dimensions of nursing: Practice, Professional Development, Collaboration and Scientific Inquiry. 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.

Background checks and security clearance

Security clearance


Required Documents

Required Documents

To apply for this position, you must provide a complete Application Package which includes:



VA Form 10-2850a - Application for Nurses and Nurse Anesthetists can be found at: ****.

The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist

to ensure you have included all documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's, etc.

Cover Letter








If you are relying on your education to meet qualification requirements:

Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education

Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.



A career with the U.S. Government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Learn more about federal benefits

Review our benefits

Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time, or intermittent. Contact the hiring agency for more information on the specific benefits offered.

How to Apply

How to Apply

All applicants are encouraged to apply online. To apply for this position, you must complete the full questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 03/21/2018 to receive consideration.

To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire.

Click Submit My Answers to submit your application package.

NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.

To verify your application is complete, log into your USA JOBS account, ****, select the Application Status link and then select the more information link for this position. The Details page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USA JOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USA JOBS account or your application will be incomplete.

Agency ****




George H OBrien Jr VA Medical Center

300 Veterans Boulevard

Big Spring, TX


Learn more about this agency

Next steps

Once your online application is submitted you will receive a confirmation notification by email. After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.

You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center

Fair & Transparent

Fair & Transparent

The Federal hiring process is setup to be fair and transparent. Please read the following guidance.

Equal Employment Opportunity Policy

The United States Government does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.

Equal Employment Opportunity (EEO) for federal employees & job applicants

Reasonable Accommodation Policy

Federal agencies must provide reasonable accommodation to applicants with disabilities where appropriate. Applicants requiring reasonable accommodation for any part of the application and hiring process should contact the hiring agency directly. Determinations on requests for reasonable accommodation will be made on a case-by-case basis.

A reasonable accommodation is any change to a job, the work environment, or the way things are usually done that enables an individual with a disability to apply for a job, perform job duties or receive equal access to job benefits.

Under the Rehabilitation Act of 1973, federal agencies must provide reasonable accommodations when: An applicant with a disability needs an accommodation to have an equal opportunity to apply for a job.

An employee with a disability needs an accommodation to perform the essential job duties or to gain access to the workplace.

An employee with a disability needs an accommodation to receive equal access to benefits, such as details, training, and office-sponsored events.

You can request a reasonable accommodation at any time during the application or hiring process or while on the job. Requests are considered on a case-by-case basis.

Learn more about disability employment and reasonable accommodations

or how to contact an agency.

Legal and regulatory guidance

Financial suitability

Social security number request

Privacy Act

Signature and false statements

Selective Service

New employee probationary period

Note: We cannot accept applications on behalf of Federal Agencies. Application instructions are listed within the Job Description.

Company info

U.S. Department of Veterans Affairs - Agency Wide
Website :

Company Profile
The Veterans Health Administration is home to the United States’ largest integrated health care system consisting of 152 medical centers, nearly 1,400 community-based outpatient clinics, community living centers, Vet Centers and Domiciliaries. Together these health care facilities and the more than 53,000 independent licensed health care practitioners who work within them provide comprehensive care to more than 8.3 million* Veterans each year.

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