| DESCRIPTION |
Member of the PACT, usually a nurse, who coordinates and manages care for
patients on the panel. This individual links patients with resources,
coordinates resources to insure provision of comprehensive care minimizing
duplication of services, manages care and ensures seamless transitions.
The Care Manager is responsible for collaborating with services internal
and external to the VA to facilitate care transition in order to
effectively meet the patients' needs. The RN Care Manager provides patient
and family health education with a focus on self-management, prevention,
and wellness, based on the patient's goals.
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