Advanced Practice Registered Nurse - Primary Care

Functions as a Nurse Practitioner (APRN) within the Patient Aligned Care Team (PACT) under Ambulatory Care Services at the Sioux Falls VA Health Care System (SFVAHCS). This position provides comprehensive primary care, advanced clinical management. The position is located at the Spirit Lake CBOC, IA and may provide support to other sites virtually or in-person as needed.

Qualified applicants will be considered and referred every 2 days until filled.

The APRN independently evaluates and manages adult and geriatric Veterans with complex medical needs using advanced clinical judgment. Duties are performed using evidence-based practice, preventive medicine principles, and VA electronic health record systems. The position generally:

1. Provides total care of Veterans' medical needs by performing histories and physical examinations, ordering and interpreting diagnostic studies, developing treatment plans, prescribing medications within scope, and coordinating follow up care. Manages patients with acute, chronic, and multi system conditions requiring advanced clinical reasoning.

2. Conducts outpatient follow up visits, acute care visits, chronic disease management, transition of care/post discharge visits, same day access encounters, and virtual visits through approved modalities (telephone, video, secure messaging, etc.).

3. Assists in preparing patients and families through education, counseling, developing patient centered care plans, and coordinating with appropriate services. Initiates health promotion and disease prevention strategies consistent with VHA guidelines.

4. Coordinates specialty consultations and provides expert guidance regarding appropriate specialty utilization.

5. Supports cross site telehealth coverage for other CBOCs and primary care locations within SFVAHCS, with an anticipated 50% of clinical time dedicated to cross-site coverage (subject to operational need).

6. Collaborates with telehealth clinical technicians and other team members to ensure smooth and effective virtual clinical operations.

7. Assists with additional Primary Care Department duties such as data assimilation for reports, participating in quality assurance programs, or other tasks determined by the Chief of Primary Care or Chief of Staff.

8. Participates in primary care Quality Improvement (QI) initiatives, peer review activities, policy/SOP development, guideline review, and committee or workgroup assignments. Provides onboarding, mentorship, or training for new APRN staff and may serve as a preceptor for Nurse Practitioner residents/students and other learners.

9. Completes all patient encounter documentation, coding, clinical reminders, and administrative requirements within established timelines. Ensures compliance with VATAS, TMS, CME, mandatory training, and all credentialing/privileging requirements.

10. Demonstrates knowledge and skills necessary to provide appropriate care for adult and geriatric Veterans. Incorporates physical, psychosocial, cultural, safety, and developmental considerations into care delivery.

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: Mon - Fri 8:00am - 4:30pm
Virtual: This is not a virtual position.
EDRP Authorized: Former EDRP participants ineligible to apply for incentive. Contact vhaedrpprogramsupport@va.gov
the EDRP Coordinator for questions/assistance. Learn more
This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.
Preferred Experience: Primary Care and/or Internal Medicine experience preferred.

Advanced Practice Nurse (Nurse Practitioner) Basic Requirements

• Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a 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).
  • NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment.
• License - All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia.
• Basic Board Certification - All APN (NPs) must maintain full and current basic board certification in one of the following: Family Nurse Practitioner (FNP), Adult Nurse Practitioner (ANP), Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), or Gerontology Nurse Practitioner (GNP) from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared.

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) assignment that are also 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.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II:
Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B).

• Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required.
• Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements:
  • Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care.
  • Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care.
  • Professional Development. Acquires knowledge and skills to develop expertise in area of practice.
  • Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III:

• Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care.
• Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level.
• Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements:
  • Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations.
  • Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program.
  • Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility.
  • Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork.