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. The following Scope, Education and Dimension criteria must be met to qualify for Nurse IV: Scope: Executes leadership that is characterized by substantial and continuous responsibility and accountability for population groups or integrated programs that cross service and/or discipline lines and influence organizational mission and health care. Education: Master's degree in Nursing (MSN) and 4 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV; OR Master's degree in a *related field with a BSN and 4 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV; OR a Doctoral degree in nursing and 3 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV; OR a Doctoral degree in a *related field with a BSN and 3 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV. *Note: Foreign education programs/degrees are not creditable as related degrees. Dimensions: Leadership. Leads health care delivery by leveraging evidence-based practices, industry-leading research, and innovative care models. Drives a shared vision and successfully leads change to improve performance and attain measurable outcomes at the program or service level. Business Acumen. Transforms health care by implementing new processes, technology, informatics, and data analytics using business models and fundamental concepts of resource management at the program or service level. Inspiring an Industry-Leading Lifestyle. Employs an industry leading, shared decision-making lifestyle. Cultivates a workforce that serves Veterans, families and caregivers of all backgrounds and builds trust, lifestyle competencies and catalyzes dynamic teams at the program or service level. Communication and Relationship Management. Directs the effective use of relationship management principles to achieve positive customer service experiences that are consistent with professional organizational values, beliefs and practices at the program or services level. Professional and Social Responsibility. Operationalizes a lifestyle of holistic care, health advocacy and health equity. Applies ethical principles in decision-making at the program or service level. Advances nursing knowledge through health science research and the translation and dissemination of evidence into practice to maximize the value to Veterans and the community. Preferred Experience: Demonstrated leadership experience with oversight of complex, cross-disciplinary healthcare programs and system-level initiatives Proven ability to manage quality, patient safety, and high-reliability initiatives, including evidence-based systems redesign and performance improvement projects Experience building and sustaining collaborative partnerships with clinicians, physicians, service chiefs, and interdisciplinary teams across a large healthcare system or VISN Background directing clinical and administrative operations within Quality Management or a similar programmatic structure Experience applying ICARE Values-Integrity, Commitment, Advocacy, Respect, Excellence-in practice leadership and organizational decision-making Familiarity with Jean Watson's Theory of Caring and its use in clinical practice environments to cultivate caring, healing, and relationship-centered care teams Ability to lead organizational policy development, participate in governance, and influence standards of care and operational priorities at the facility or network level Experience supporting or leading a High Reliability Organization (HRO) with a strong culture of safety, transparency, and system-focused problem solving Demonstrated competency in data analytics, business acumen, resource utilization, and strategic program management in a healthcare environment Successful track record cultivating a diverse and inclusive workforce, addressing disparities, and integrating cultural health practices into care delivery Advanced skill in communication and relationship management, including conflict resolution, customer service excellence, and building trust at all organizational levels Experience developing and operationalizing holistic care, health advocacy, and ethical decision-making frameworks for large teams or systems Prior involvement in translating evidence-based research into clinical practice and designing systems to improve quality outcomes across departments or programs Ability to adapt effectively to complex, changing environments, balancing multiple priorities and leading change initiatives with measurable impact on patient care Certified Professional in Healthcare Quality through NAHQ Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.