VISN 1 CRH Registered Nurse- Tele-Nephrology (Clinical Resource Hub)

Full Job Description

This position is in the Clinical Resource Hub (CRH) at the VA Connecticut Healthcare Systems, located in West Haven, CT. This position is full-time at 40 hours per week.

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.

Preferred Experience: Experience providing comprehensive nephrology nursing care, including assessment and ongoing management of chronic kidney disease (CKD), acute kidney injury (AKI), electrolyte disorders, hypertension, and kidney-related complications across diverse Veteran populations.

Advanced skill in remote clinical management of nephrology patients, including interpretation of home monitoring data (blood pressure logs, weight trends, symptom monitoring), review of laboratory trends, and timely escalation of care needs.

Demonstrated proficiency in supporting Veterans using virtual care technologies, including remote patient monitoring (RPM) platforms, telehealth devices, secure messaging, and video visits-providing education, troubleshooting, and guidance for technology-enabled cared.

Experience coordinating pre- and post-dialysis care across modalities (in-center hemodialysis, home hemodialysis, and peritoneal dialysis), including remote monitoring of dialysis-related parameters, patient education, and assessment for treatment-related complications.

Familiarity with management of nephrology-specific therapies (e.g., anemia management, mineral bone disorder treatment, immunosuppressive medications) with the ability to review lab results, document assessments, and contribute to medication titration per protocol or provider guidance.

Strong skills in Veteran and caregiver education, with the ability to deliver individualized teaching on CKD self-management, lifestyle modification, blood pressure control, fluid management, and adherence to complex treatment plans in a virtual environment.

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/12901562.

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.

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

Physical Requirements: Position is subject to a pre-employment physical and medical examination.

This position requires: lifting, carrying; reaching above shoulder; use of fingers; walking (8 hours); standing (8 hours); repeated bending; working alone; protracted or irregular hours of work and occasional emotional strain.

Major Duties:

The Clinical Resource Hub (CRH) Tele-Nephrology Registered Nurse (RN) provides advanced clinical, technical, and programmatic support essential to sustaining high-quality virtual nephrology care across the Veterans Integrated Services Network (VISN).

The Tele-Nephrology RN demonstrates leadership, independent clinical judgment, and innovative approaches to managing complex kidney-related conditions in a virtual environment.

Duties include but are not limited to: Supports all VISN 1 Hub locations for the enterprise-wide initiative that are involved in the delivery of virtual nephrology services, including VA medical centers, community-based outpatient clinics, and provider alternate worksites, ensuring seamless care across distributed environments.

Manages incoming and outgoing VISN 1 CRH nephrology consults, ensuring timely review, appropriate triage, accurate assignment, and coordination of follow-up actions consistent with established national and VISN consult management standards.

Provides enterprise-wide support to the VISN 1 CRH, delivering synchronous and asynchronous Tele-Nephrology services to Veterans within and outside the VISN when needed.

Provides direct virtual patient care to one or more panels of nephrology patients, including those with chronic kidney disease (CKD), hypertension, fluid and electrolyte disorders, kidney transplant follow-up needs, and dialysis-related concerns.

Conducts remote assessments using telehealth technologies, interprets home monitoring data (blood pressure, weight, symptoms), reviews lab values, identifies early signs of deterioration, and escalates findings consistent with clinical protocols.

Coordinates laboratory scheduling, virtual visit workflows, consult and visit triage, care coordination, and longitudinal follow-up for nephrology patients receiving virtual care.

Facilitates smooth transitions of care between Primary Care, Nephrology, dialysis providers, Pharmacy, Nutrition, Social Work, and other interdisciplinary team members, minimizing fragmentation and ensuring continuity across virtual and in-person services.

Engages Veterans and caregivers in shared decision-making, providing tailored education on CKD self-management, blood pressure control, fluid and dietary management, medication adherence, and preparation for advanced kidney therapy options.

Delivers telephone and video-based clinical triage, responding to patient concerns, reviewing symptoms, identifying urgent needs, and ensuring timely access to appropriate nephrology or acute care services.

Provides comprehensive care management, ongoing monitoring, and coordination services, acting as an advocate for the Veteran to ensure timely receipt of recommended evaluations, treatments and follow-up care.

Supports, trainings, and collaborates with CRH and spoke-site staff on Tele-Nephrology workflows, virtual care technologies, remote monitoring platforms, and best practices in virtual nephrology nursing.

High-level clinical reasoning and decision-making skills, including the ability to identify early signs of clinical deterioration through virtual assessments, triage appropriately, and provide accurate, timely documentation within VA digital health systems (CPRS, JLV, RPM platforms, etc.).

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: Full-time, Monday-Friday, 8:00am - 4:30pm Remote: This is a remote, exempted/mid-term extension position.

Exempted/Mid-term extension positions are reviewed regularly and do not imply permanent remote status. Virtual: This is not a virtual position. Financial Disclosure Report: Not required.

Notifications: This position is not a Bargaining Unit position. Current and former Federal employees must submit copies of their most recent SF-50 (Notice of Personnel Action).

The SF-50 must identify the position title, series, grade, step, tenure and type of service (Competitive or Excepted).

In some cases, more than one SF-50 may be required to show a higher grade previously held. This position is in the Excepted Service.

The salary is based on the grade and step approved for the selected candidate.