The Utilization Management (UM) Nurse works with a team of professionals to insure appropriate utilization of bed resources at the VA Salt Lake City Health Care System (VASLCHCS). The Nurse applies current performance improvement, education and data management concepts. The Nurse performs clinical audits which include: review of medical record documentation, evaluating the quality of patient care and monitoring the appropriateness and timeliness of services provided.

Duties

VA offers a comprehensive total rewards package: VA Nurse Total Rewards The Utilization Management Nurse will complete timely reviews with supporting data entry and assist in the identification of pertinent recommendations to healthcare providers and administrators for improved quality of care and resource utilization. Major Duties: Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization management program. Performs admission and continued stay reviews utilizing the InterQual Criteria for inpatients at the VA Salt Lake City Health Care System. Educate physicians, residents, interns, medical and nursing staff on documentation requirements necessary to meet InterQual criteria. Assists in quality improvement activities including data collection, data tracking, report formation, and participation on improvement teams. Possess a strong clinical knowledge of a range of adult to geriatric diseases. The knowledge base is preferred in Medicine, Surgery and/or Psychiatry. Performs analysis of Joint Commission, Office of Inspector General (OIG), VISN, and VHA Office of Quality, Safety and Value (QSV) - Utilization and Efficiency Management standards. Identifies those standards pertinent to utilization management and to alert facility leaders to potential vulnerabilities. Able to work in a fast paced, changing environment. Self-directed in goal setting. Identifies and escalate quality of care issues through established channels. Utilizes negotiation skills to secure appropriate options and services necessary to meet patient healthcare needs. Position requires proficiency with computer skills which includes navigating the electronic medical record and keyboarding. Effective communication skills, both verbal and written. Other duties as assigned. 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: Monday - Friday; 7:30am to 4:00pm Telework: Not Available Virtual: This is not a virtual position. Financial Disclosure Report: Not required

Requirements

Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency. In accordance with 38 U.S.C. 7402(d), 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 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). 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. In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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. 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. Preferred Experience: Master's prepared registered nurse; 3 years of Utilization Management/Chart Review/Utilization Review experience. Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade: Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required. Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience. Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience. Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 years of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 years of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required. Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 years of nursing practice/experience; OR a Doctoral degree and approximately 2-3 years of nursing practice/experience. Note regarding MSN degrees: If your MSN was obtained via a Bridge Program that qualifies for professional nursing registration, a BSN is not required. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: The position involves considerable standing, walking, stooping, bending, reaching, lifting, and turning. It requires restraining confused patients, repositioning patients, assisting with transferring patients to Wheelchairs/stretchers/cars, and transporting them to other departments or facilities. Mechanical devices available and are required to be used for heavy or difficult to lift patients. The work may involve pushing or lifting weight in excess of 50 pounds and going up and down flights of stairs. 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. This position requires visual acuity, good hearing, distinctive speech and manual dexterity. The position requires the nurse to work for periods of time with arms above shoulder level with neck in a fully flexed or extended position and the ability to physically control or protect his/herself from physically abusive patients.

Education

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.

Contacts

• Address VA SALT LAKE CITY HCS 500 Foothill Drive Salt Lake City, UT 84148 US
• Name: Karen Blackmon
• Phone: (303) 202-8286
• Email: [email protected]