Utilization Management Registered Nurse

<p>Demonstrates integration of biopsychosocial concepts, cognitive skills, and technically competent practice while providing care to clients. Assesses, plans, implements, and evaluates care based on age-specific components.</p><h3>Major Duties</h3><p>Major duties may include but are not limited to: Perform timely Utilization Management (UM) reviews across Medicine, Surgery, and Behavioral Health. Collaborate with ED and inpatient physicians and provide level of care recommendations that ensure continuity across reviewers. Participate in daily interdisciplinary rounds to identify appropriate alternate levels of care. Support quality, patient safety, and resource stewardship through accurate, timely UM activities. Provide education to physicians, residents, and interdisciplinary staff on UM criteria, documentation requirements, LOC determinations, and organizational expectations to promote accurate, consistent application of UM principles. Self-directed in professional development activities Applies high reliability principles and ICARE values to improve patient outcomes. Demonstrated positive, effective communication skills and professional behaviors that promote cooperation and teamwork with internal and external customers. Participates in continuous process improvement (CPI) activities by identifying workflow gaps, recommending evidence-based solutions, and applying Lean or PDSA methods to improve UM efficiency, documentation quality, and patient flow; support tracking and reporting of improvement initiatives in alignment with facility CPI expectations. 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: 7:30am -4:00pm Compressed/Flexible: Not Available Telework: AD-HOC Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized</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>Note: Only education or degrees recognized by the Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE) may be used to qualify for nursing positions. The approving official may authorize a waiver of the requirement for ACEN or CCNE accreditation of any degree in nursing provided the college or university has regional accreditation from an accrediting body recognized by the Department of Education at the time of the candidate's graduation and the composite qualifications of the applicant warrant such consideration. You can verify your education here if it was not accredited by ACEN or CCNE at the time of graduation: 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.