Utilization Management Registered Nurse

<p>The Albuquerque VA is looking for Utilization Management Registered Nurse for Care Coordination in Operations Service!</p><h3>Major Duties</h3><p>The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization processes. Practical experience in the application of UM methods and expertise in medical necessity review criteria. This position requires strong analytical skills and the ability to evaluate program structure, process, and effectiveness and recommend strategies for program improvement. The UM RN is responsible for participating in field UM program review activities and providing advanced clinical and administrative recommendations and consultation to local and VISN UM staff. Possesses comprehensive knowledge of clinical appropriateness, functions, processes, and principles of utilization management. They must have strong interpersonal communication skills to instruct UM staff in medical necessity criteria and interact with all levels of clinical and administrative leadership across the facility. They possess excellent fact-finding and problem-solving skills, including familiarity with statistical analysis and nonparametric data. They have advanced knowledge in the utilization management and workload data sources available and serves as a resource to help UM programs analyze and display UM outcomes to highlight quality and efficiency improvement opportunities. They are experienced in performance improvement and/or systems redesign methodology and use this knowledge to guide system improvement in process and resource use at the local and network level. They must have a successful track record of successfully managing multiple priorities while maintaining a focus on quality and detail. 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: 0630-1500 M-F (hours may vary) Telework: Not Available 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. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). As a condition of employment for accepting this position, you will be required to serve a 2-year probationary period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider: Your performance and conduct; The needs and interests of the agency; Whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service. Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest. Complete all application requirements detailed in the "Required Documents" section of this announcement.