The RN Utilization Management Case Manager (UMCM) is responsible for the ongoing development and maintenance of a continuous readiness program which ensures facility accreditation and compliance with external accrediting standards and internal performance expectations as delineated in VHA guidelines and directives. This position is located within the Central Texas VA Health Care System (CTVHCS) in Waco, TX.

Duties

Provides guidance within an enterprise risk management framework, driving improvement and developing processes which support safe and efficient patient care delivery. Leads both large and small interdisciplinary groups seeking system systems improvement outcomes, teaching, writing, chart review, data extraction, evaluation and trending, electronic data reporting, priority-setting, and critical thinking skills. Accountable for utilizing critical thinking skills and sound judgement to ensure positive outcomes, maximizing third-party collections and delivering quality patient care performance improvement activities. Develops and coordinates seamless transitioning of patients throughout the care process. Demonstrates knowledge and ability to apply principles of evidence-based practice. Works independently with minimal supervision, exhibits sound decision-making and organizational skills, and has the ability to set priorities. Responsible for coordinating, developing, executing, monitoring, and evaluating all case management activities. Activities encompass utilization review, resource management, coordination of care, transition/discharge planning, and across the board episodes of care. Promotes and facilitate patient movement throughout the healthcare continuum with the development and implementation of processes and procedures that ensures timely and proactive case manager and social worker interventions. Conducts assessments for appropriateness of admission, continued stay and to facilitate and expedite discharge of patients using established criteria. Facilitates the initiation of diagnostic series, treatment, planning, and therapeutic treatment. Collaborates with social workers on referrals to alternate levels of care, ensuring appropriate utilization of resources to improve the quality of patient care. Identifies patients and families who have complex, psychosocial, financial, and/or legal needs, referring them to correct resources and management teams. Collaborates with Physician Advisor's coordinates plans of care, develops clinical practice guidelines and critical pathways and assists is facilitating communication with other case managers and utilization management staff. Work Schedule: Monday - Friday, 0800-1630 Telework: Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized Financial Disclosure Report: Not required Bargaining Unit Status: This position is part of the bargaining unit. 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

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. Education: 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. License: 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: Evidence of Belt/Systems Redesign training/experience/certification SNT/GNT/RNTTP completion

Education

EDUCATION ACCREDITATION: The Associate Degree in Nursing (ADN), Bachelor of Science degree in Nursing (BSN), or Master of Science Degree in Nursing (MSN) must be recognized by the appropriate State-accrediting agency and accredited by either of the following accrediting agencies at the time the program was completed by the applicant:

1. The Accreditation Commission for Education in Nursing (ACEN) OR
2. The Commission on Collegiate Nursing Education (CCNE)
3. ACEN/NLNAC or CCNE program or degree accreditation may also be found under the U.S. Department of Education

NOTES:

• Department of Education: 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/.
• Foreign Education: 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.
• School Name: If your school has changed names, or is no longer in existence, you must provide this information in your application.
• No longer on accreditation site: If your school was accredited by ACEN or CCNE at the time of graduation, but is no longer listed on the websites, you must provide documentation of accreditation with your application packet

IMPORTANT - Transcript: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Contacts

• Address VA Central Texas Health Care System 1901 Veterans Memorial Drive Temple, TX 76504 US
• Name: VISN 17 SSU USAS Group
• Email: [email protected]