Registered Nurse (RN) Care Manager

Company Description

International SOS Government Medical Services, Inc. delivers customized medical and security risk management and wellbeing solutions to enable our clients to operate safely and effectively in environments far from home. Founded in 1984, we operate in 92 countries providing integrated medical solutions to organizations with international operations. Our innovative technology and medical and security expertise focus on prevention, offering real-time, actionable insights and on-the-ground quality delivery. We provide clinical services to include “hands on” direct care at over 800 sites around the world, many of which include inpatient clinical care capabilities. With 12,000 staff (including 5,200 medical and behavioral health providers) our services include the design, deployment, and operation of healthcare solutions including freestanding surgical facilities in remote and austere environments, telemedicine consultation through a wide range of virtual modalities, referrals to a global network of more than 100,000 vetted providers, and global aeromedical evacuation. Within our portfolio of companies, International SOS Government Medical Services, Inc., headquartered in Houston, Texas provides contracted healthcare support to Government defense and civil agencies and government contractors, including support to military exercises and operations, diplomatic missions, natural disasters, and refugee care. To protect your workforce, we are at your fingertips: internationalsos.com

Job Description

This position is contingent upon award:

The Registered Nurse (RN) Care Manager functions as the primary RN within a Patient Aligned Care Team (PACT) at a VA Community Based Outpatient Clinic. The RN Care Manager provides proactive, Veteran-centered care through care coordination, clinical triage, chronic disease management, preventive services, health coaching, and population health outreach. The role emphasizes safety, access, quality, and whole health while collaborating closely with providers, LPN/MAs, behavioral health, pharmacy, and social work to achieve optimal outcomes.

• Serve as the PACT RN for an assigned patient panel; coordinate care across visits, settings, and services.
• Perform RN triage (in-person/telephone/video) and implement evidence-based protocols; escalate per clinical judgment.
• Develop, implement, and adjust patient-centered care plans; support self-management and whole health goals.
• Coordinate referrals, consults, and transitions of care; ensure closed-loop follow-up and test/result tracking.
• Lead post-discharge calls and high-risk outreach to reduce readmissions and ED utilization.
• Use registries/dashboards to identify and close care gaps (immunizations, screenings, chronic disease control).
• Conduct risk stratification and targeted outreach (e.g., uncontrolled A1c/BP, high ED use, missed appointments).
• Run pre-visit planning and daily huddles; ensure needed labs, imaging, and referrals are completed prior to visits.
• Provide nursing interventions within scope: medication administration, wound care, immunizations, EKGs, specimen collection, and patient education.
• Assist with procedures and perform nurse visits per standing orders and protocols.
• Respond to in-clinic emergencies; act as charge/lead RN as assigned.
• Adhere to VA directives, nursing standards, infection prevention, and medication safety policies (HIPAA/Privacy, OSHA, CLIA as applicable).
• Participate in quality improvement (PDSA cycles), audit readiness, and event reporting/resolution.
• Ensure timely, accurate documentation using clinical reminders and standardized RN note templates.
• Support access targets (same-day access, third-next-available) through RN-led protocols, virtual care, and efficient workflows.
• Reduce cycle time via in-rooming efficiency, nurse-driven order sets, and effective teamwork.
• Provide trauma-informed, culturally competent care; participate in service recovery and SHEP/CX action plans.
• Document assessments, interventions, care plans, and education in the VA EHR (e.g., CPRS/Cerner) in accordance with policy.
• Use population health tools to monitor outcomes and communicate trends to the team.
• Safeguard Veteran privacy and information security in all workflows.
• Completes required organizational compliance education, including assigned requirements that are client-specified, for Joint Commission Healthcare Staffing Services certification or other regulatory bodies.

This list is non-exhaustive, and the role holder may be required to undertake additional duties
that are not specifically listed above.

Qualifications

Required Skills and Knowledge:

• Strong clinical assessment and triage skills with sound judgment and escalation practices.
• Team-based mindset