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RN Case Manager - Home Based Primary Care - Oakland

VA Medical Center

Oakland, CA
Job Code:
  • Medical/Surgical
  • Case Manager
  • Hospice/Palliative Care
  • Infection Control
  • Long Term Care
  • IV Therapy
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Job Details

Job Detail - VA Careers

RN Case Manager - Home Based Primary Care - Oakland
Oakland, CA


Relocation Expenses: Relocation expenses are not

authorized for this position.




1.       Demonstrated clinical competencies in such areas as age-specific care, cultural assessment, and health education.

2.       An ability to effectively function autonomously, as well as a member of an interdisciplinary team

3.       Respect for cultural and spiritual values.

4.       A commitment to discipline-specific standards of practice, including:  ethical conduct, the primary care delivery model, chronic disease management, palliative care, principles of care management, a holistic framework of practice, and geriatric care skills (including infection control, equipment and environmental safety).

5.       Determine the appropriateness of patients for admission into the HBPC Program.

6.       Help develop patient treatment plans based on a comprehensive interdisciplinary assessment of the patient and the caregiver.

7.       Implement the patient's treatment plan through home visits, as needed.

8.       Review the patient's progress as a team at regular intervals, at least every 90 days, or when there is a change in the patient's condition.

9.       Assess and support the caregiver's capability to continue to provide care.

10.   Educate the patient and the caregiver.

11.   Coordinate the process of care with the other team members to maximize efficiency.

12.   Assess the patient's continuing need for HBPC care, and plan for HBPC discharge when indicated.

13.   Document all patient care activities in a timely manner (per facility policy).

14.   Identify areas for continuing education and participate in in-service training (including staying current with all required education).

15.   Participate in developing and implementing the performance improvement plan (including quality monitors).

16.   Instruct students of various disciplines in the challenges encountered in delivering health care in the home setting. 

17.   Serve as a role model in the effective operation of an interdisciplinary team.

18.   Participate in the development and periodic review of the local HBPC Policy and Procedure Manual.

19.   Utilize VHA and community resources as appropriate.

20.   Participate in HBPC team meetings.

21.   Case management of 20-30 patients.


Best Care / Best Careers

To care for him who shall have borne the battle and for his widow and his orphan." These words, spoken by Abraham Lincoln during his Second Inaugural Address, reflect the philosophy and principles that guide VA in everything we do, and are the focus of our endeavors to serve our Nation's veterans and their families.

 The Department of Veterans Affairs (VA) has one of the most diverse, challenging, and rewarding missions in the United States Government. We strive to meet the needs of the Nation's veterans and their families today and in the future.

VA manages one of the largest health care systems in the world and the nation's leading employer of registered nurses. Nurses in Veterans Health Administration (VHA) are engaged in a variety of roles and have multiple opportunities for career and professional development. The VHA provides veterans and their dependents with many other services such as benefits and education, and also provides burial benefits.

Our goal is to provide excellence in patient care, veterans' benefits and customer satisfaction. We can provide you with challenging, interesting, meaningful work to care for the veterans who have risked their lives to protect our freedom.

 As the Department of Veterans Affairs heads into the 21st century, we will strive to meet the needs of the Nation's veterans today and tomorrow. We are a more customer-focused organization, functioning as "One-VA" and delivering seamless service to our customers.

We benchmark our service with the best in business. We use innovative means and high technology to deliver "World-Class Customer Service". We foster partnerships with our customers and stakeholders, making them part of the decision-making process.

Department of Veterans Affairs is an Equal Opportunity Employer.

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