Registered Nurse, Utilization Mgmt

<p>The Registered Nurse, Utilization Management is responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care.</p><h3>Major Duties</h3><p>Delivers fundamental knowledge-based care to assigned clients while developing technical skills. Assesses, plans, implements, and evaluates care based on age-specific components. Assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care. Follows procedures per established policies and guidelines. Influences care outcomes by collaborating with members of the interdisciplinary team. Collects, monitor, interprets and communicates pertinent clinical data, applies InterQual criteria and enters information into a national database as required. Functions or Scope of Assigned Duties: The Utilization Management (UM) RN demonstrates a high level of clinical practice, knowledge, and leadership skills to improve patient access, flow, and positively impact the facility utilization of services. The UM RN will be aligned within Patient Business Service and must work independently in accomplishing assignments and program goals. He/she possesses knowledge of utilization review criteria, UM processes and principles, clinical documentation requirements, current standards of care and compliance guidelines. As a clinical reviewer he/she serves as the QM liaison creating effective lines of communication with medical center leadership, staff, and internal/external customers. He/she collects, interprets and communicates pertinent clinical data, applies InterQual criteria and enters information into a National database. 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: 06:30am to 3:00pm Monday - Friday Telework: Ad-hoc Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required</p><h3>Requirements</h3>U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Must pass pre-employment physical examination. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). You may be required to serve a probationary period. Complete all application requirements detailed in the "Required Documents" section of this announcement.<h3>Education</h3>IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.