The Revenue Utilization Review (RUR) Assistant Nurse Manager (ANM) is a Registered Nurse (RN) who assists to control costs for VISN 10 and/or VISN 12 while monitoring the quality of care through critically examining patient medical records, paying close attention to the appropriateness of healthcare expenditures. The RUR ANM relies on experience, education, and awareness of appropriate evidence-based review criteria to compile an accurate account of patient clinical pictures.

Duties

The Revenue Utilization Review (RUR) Assistant Nurse Manager (ANM) is directly responsible for the oversite and leadership of staff and the department to accomplish business operations of the RUR team and the mission of the VA. The RUR ANM is responsible for providing leadership and supervision to the RUR staff nurses who validate and Program Support Assistants (PSAs) who screen (PSAs use algorithm) service connection (SC) and special authority (SA) eligibility before relaying any information to external reviewers representing third-party payers (TPPs). The RUR ANM possesses clinical and nurse leadership skills and demonstrates this through communication, mentoring and grade-appropriate critical thinking. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Responsibilities of the RN ANM include the following: * He/she is responsible to contribute to a safe, healthy working environment that supports the work of the RUR nursing unit and is influential in creating a professional nursing environment and fostering a culture where interdisciplinary team members are able to contribute to optimal program outcomes and grow professionally. * He/she guides designated subordinates to collaborate and coordinate among interprofessional team members involved in each patient's care to draw team members' input and form the most comprehensive clinical picture, which the staff nurse then relays to insurance reviewers. * The successful RUR ANM possesses expertise in leading people and creating change within the unit to support the mission of the VA. * The RUR ANM's primary commitment is to the patient, whether an individual, family, group, or community (ANA Code of Ethics for Nurses). * Assist in Leading and organizing the RUR nursing program to ensure continuity of operations, peer accountability, organizational needs, and consistency in nursing practice. * Reads and correctly interprets CPAC RUR policies, procedures, and guidelines to ensure staff compliance. * Contributes to the RUR program through process improvement initiatives and RQC processes. * Functions as a competent consultant in clinical practice to RUR staff, CPAC Leadership, and VA medical facilities regarding the Revenue Utilization Review procedures. * Systematically evaluates current practice and formulates outcomes for groups of nurses, patients, and/or organizational processes. * Participates in establishing goals, solving problems, and collaborating with other departments both in the facility and in the CPAC to enhance the Revenue Utilization Review program. * Work toward current and future software efficiency to perform workload tasks. * Possess the capability to learn data analytics to track, monitor and trend revenue recovery and workload. * Counsel and train staff on current and new processes while monitoring staff efficiencies. * The RUR Assistant Nurse Manager must be an individual capable of working effectively in stressful situations and able to shift priorities based on organizational needs. * The Assistant Nurse Manager functions as a supervisor and provides administrative and clinical supervision and general instruction, plans and assigns work, assigns time schedules, approves leave and completes performance evaluations for employees designated under their direct supervision. * The Assistant Nurse Manager is self-directed and works under moderate supervision and instruction by the RUR Nurse Manager. 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: 07:00am - 4:00pm Flexible: Available Telework: ADHOC Available Virtual: This is not a virtual position. Financial Disclosure Report: Not required

Requirements

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 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: Prior management experienced preferred. Leadership experience within VHA, excellent oral and written communication skills, and knowledge of revenue processes and/or revenue utilization review. 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. 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: This position requires visual acuity, hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued sitting and computer use and typing. The RUR Assistant Nurse Manager must be an individual capable of working effectively in stressful situations and able to shift priorities based on organizational needs.

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 NCCPAC Madison 8001 Terrace Ave Middleton, WI 53562 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]