Assistant Chief Nurse-Outpatient and Specialty Care

Full Job Description

The Assistant Chief Nurse (ACN) Outpatient and Specialty Care demonstrates leadership characterized by substantial and continuous responsibility and accountability for complex population groups and integrated clinical programs that cross service, discipline, and organizational lines.

The scope of influence extends beyond individual units to service, facility, VISN, and system levels, directly impacting organizational mission, healthcare delivery, and measurable patient care outcomes.

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.

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/12930861.

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.

Preferred Experience: A minimum of four (4) years of nursing practice, two (2) years of which should be in leadership positions, an emphasis on specialized Outpatient: Primary and Specialty care.

Experience with policy development, shared governance, and HRO principles. Regulatory & Compliance Knowledge: OIG, VISN, VHA, and Joint Commission.

Ability to mentor and develop nursing staff at all levels. Strong skills in care coordination and interdisciplinary collaboration.

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

Physical Requirements: Lifting up to 35·pounds for 8-12 hours, intermittently, moderate carrying (15-35 pounds) for 8 to 12 hours, intermittently, lifting over 35 pounds with assistive devices in accordance with the Safe Patient Handling Policy except in emergent situations requiring prompt patient care, pulling for 8 to 12 hours intermittently, pushing for 8-12 hours, intermittently, reaching above the shoulders for 8-12 hours, intermittently, both hands required, walking 8-12 hours, intermittently, standing 8-12 hours intermittently, kneeling 8 to 12 hours, intermittently, repeated bending for 8-12 hours, intermittently, climbing and use of both legs and arms for 8-12 hours, intermittently, both legs required, near vision at 13 to 16" Jaeger 1 to 4, far vision correctable in one eye to 20/20 and to 20/40 in the other eye, ability to distinguish basic colors, hearing aid permitted, twisting, simple grasp and fine manipulation.

Major Duties:

The Assistant Chief Nurse utilizes a comprehensive, systems-focused approach to nursing leadership that emphasizes evidence-based practice, innovation, and adaptive care delivery.

By applying principles of complexity science, systems theory, and healthcare management, the role evaluates and responds to the dynamic nature of outpatient and specialty care environments, ensuring care models remain responsive, efficient, and aligned with evolving Veteran needs.

The Assistant Chief Nurse drives the implementation of evidence-based and innovative nursing interventions across microsystems and broader programmatic levels to optimize care delivery and outcomes for diverse populations.

The role synthesizes evidence and employs advanced analytical and improvement science methodologies to develop, implement, and evaluate health promotion, disease prevention, and population-based strategies that address complex clinical and operational challenges.

The Assistant Chief Nurse applies public health principles and evaluates social drivers of health to inform the development of comprehensive, equitable care programs that reduce disparities and improve access and outcomes across outpatient and specialty care services.

Program outcomes are broad, complex, and demonstrable across organizational levels.

The Assistant Chief Nurse is responsible and accountable for all elements of the nursing process when providing, coordinating, or supervising care.

This includes oversight of nursing practice, personnel, and clinical resources to ensure the delivery of safe, high-quality, patient- and family-centered care throughout the continuum.

The role ensures coordination of care focused on patient education, self-management, satisfaction, and continuity, while adhering to established policies, procedures, and clinical guidelines.

The ACN spearheads quality improvement initiatives using data-driven approaches, advanced performance measurement, and benchmarking against rigorous internal and external standards.

The role evaluates care outcomes, identifies system-level variation, and adapts strategies to support continuous improvement in quality, safety, access, and patient experience.

Risk identification and mitigation strategies are implemented to optimize patient safety across outpatient and specialty programs.

The ACN functions as a self-directed clinical leader, consultant, and collaborator, utilizing management theory in partnership with Patient Care Service and interdisciplinary stakeholders.

Effective communication and leadership facilitate collaboration across nursing, medical, and administrative teams to navigate complex care scenarios and achieve shared outcomes.

The role assists and supports Nurse Managers in fulfilling operational, clinical, and administrative responsibilities, providing guidance that strengthens frontline leadership and accountability.

Leadership is demonstrated at the service and facility level through appropriate delegation, functional oversight, and strategic support to the Associate Chief of Nursing Service, Outpatient and Specialty Care.

Responsibilities include oversight of specialty and procedural programs, participation in aggregate data analysis, and engagement in budget planning to anticipate current, emerging, and future resource needs.

The ACN leads decisions related to resource allocation based on patient care systems that produce high-quality, cost-effective outcomes.

The ACN provides coordination and accountability for regulatory, accreditation, and environmental surveys, ensuring compliance with applicable directives, policies, standards, and standard operating procedures, and adherence to mandatory response timelines.

Active participation in quality improvement, customer service initiatives, and organizational performance activities is a core element of performance.

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: 08:00am-04:30pm Telework: Available Ad Hoc Only Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized