Registered Nurse, Utilization Mgmt

**Summary** 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. **Qualifications** 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 * Grade Determinations: The following Scope \- Education and Dimension criteria must be met in determining the grade assignment of candidates \- and if appropriate \- the level within a grade * The Dimension requirements (Practice \- Veteran/Patient Driven Care \- Leadership \- Professional Development and Evidence\-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/12974730 * Grade/Level Scope Education Nurse I \- Level I Delivers fundamental \- knowledge\-based care to assigned clients while developing technical competencies * An Associate Degree (ADN) or Diploma in Nursing \- with no additional professional nursing required * Nurse I \- Level II Demonstrates integration of biopsychosocial concepts \- cognitive skills and technically competent practice in providing care to clients with basic or complex * An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I \- Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required * Nurse I \- Level III Demonstrates proficiency in practice based on conscious and deliberate planning * Self\-directed in goal setting for managing complex client situations * An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I \- Level 2 * OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I \- Level 2 * OR a Master's degree in nursing (MSN) and no additional professional nursing experience * OR a Master's degree in a \*related field with a BSN and no additional professional nursing experience * Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others * A BSN with 2 years of professional nursing equivalent to Nurse I \- Level 3 * OR an MSN with one year of specialized nursing experience equivalent to Nurse I \- Level 3 * OR a Master's degree in a \*related field with a BSN and one year of specialized nursing experience equivalent to Nurse I \- Level 3 * OR a Doctoral degree in Nursing with no professional nursing experience * OR a Doctoral degree in a \*related field with a BSN with no additional professional nursing experience * Nurse III Executes position responsibilities that demonstrate leadership \- experience and creative approaches to management of complex client care beyond the immediate practice setting * MSN and 2 years of specialized nursing experience \- one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III * OR a Master's degree in \*related field with BSN and two years of specialized nursing experience \- one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III * OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III * OR a Doctoral degree in a \*related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III * \*Note: Foreign education programs/degrees are not creditable as related degrees * Reference: For more information on this qualification standard \- please visit https://www.va.gov/ohrm/QualificationStandards/ * Physical Requirements: This position requires visual acuity \- keen hearing \- clear distinctive speech \- and manual dexterity * This position requires potentially long periods of continues walking \- standing \- stooping \- sitting \- bending \- pulling \- and pushing * Transferring patients and objects may be required * The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations or operative/ invasive procedures * The incumbent may occasionally be exposed to patients who are combative secondary to delirium \- dementia \- or psychiatric disorders * The incumbent must be a mature \- flexible \- sensible individual capable of working effectively in stressful situations \- able to shift priorities based on patient needs. Duties * 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