The RN Utilization Management position is at the VA in San Antonio. The RN is responsible for utilizing evidence based InterQual criteria to conduct prospective, concurrent, and retrospective reviews using the National Utilization Management Integration database.

Duties

The Registered Nurse for the Utilization Management position will work predominately in the emergency department to assess and collect health data and make recommendations to the provider on the most appropriate level of care for the patient and determine if the patient meets medical necessity for the hospital stay. Additional duties include but are not limited to: Responsible for utilizing InterQual criteria and conducts InterQual reviews using the National Utilization Management Integration database, successfully passes the Inter-Rater reliability exams annually. Assesses and collects health data based on the InterQual criteria and communicates to an interdisciplinary team, developing plans for those patients not meeting InterQual Criteria and noting the right level of care. Monitors admission and continued stay criteria identifying potential process deficiencies, makes suggestions for improvement, and reports discrepancies through the appropriate chain of command. Interprets federal regulations, VHA guidelines, medical review criteria, utilization management processes, clinical documentation requirements, current standards of care, and compliance guidelines. Demonstrates leadership in delivering and improving holistic care for Veterans through collaborative, courteous, timely, patient centered communication with all medical disciplines within the South Texas Veterans Health Care System. Serves as a resource person and serve as a consultant for problem solving nursing and organizational issues. Identifies trends and develops actions plans and/or participates in service or organizational projects to improve services with measurable, sustainable outcomes. Participates in Nursing Service and medical facility committees. 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: 8-12 hour Rotating Shifts to include nights/weekends/holidays. Tour specifics to be discussed during interview process. Telework: Ad-Hoc (Occasional or Irregular basis) Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized 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: Able to communicate effectively with internal and external customers 3-5 years recent Clinical Experience 2-5 years recent Interqual Experience Ability to analyze and compile data 2-3 years experience managing teams and/or programs 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 requires compliance with VA Handbook and VASTHCS Policy related to physical requirements. Moderate Lifting of 15-44 pounds, Moderate carrying of 15-44 pounds, Straight pulling for 1 hour, Pushing for 1-3 hours, Reaching above should, Use of fingers, Both hands required, Walking 4 hours, Standing for 2-7 hours, Kneeling for 2 hours, Repeated bending for 2 hours, Climbing and use of both legs and arms, Both legs required, Ability for rapid mental and muscular coordination simultaneously, Near vision at 13 to 16" Jaeger 1 to 4, Specific visual requirement of 20/40 DVA; corrected, Both eyes required, Ability to distinguish basic colors, Hearing (aid may be permitted), Sitting for 8 hours, Simple grasping for 2-4 hours, Fine manipulation (including keyboarding for 4-6 hours), Twisting for 2 hours, Mental and emotional stability.

Education

The Associate Degree Nursing (ADN), Bachelor of Science degree in Nursing (BSN), or Master of Science degree in Nursing (MSN) must be fully accredited by the Accreditation Commission for Education in Nursing (ACEN) or the Commission On Collegiate Nursing Education (CCNE). Verification of accreditation may be obtained from http://www.acenursing.us/accreditedprograms/programsearch.htm or https://directory.ccnecommunity.org/reports/accprog.asp

• If your school has changed names, or is no longer in existence, you must provide this information in your application.
• 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: 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 Audie L Murphy Memorial Veterans Hospital 7400 Merton Minter Boulevard San Antonio, TX 78229 US
• Name: VISN 17 SSU USAS Group
• Email: [email protected]