The Registered Nurse, Utilization Management Coordinator delivers fundamental, knowledge-based care to assigned patients while developing competencies. They demonstrate leadership in delivering and improving holistic care through collaborative strategies with others, and demonstrates concepts of cognitive skills and technically competent practice in providing care to patients with basic or complex needs.

Duties

Major Duties include, but are not limited to: Performs unit based inpatient case management duties, with the ability to perform RN case management assessments, discharge planning, formulating safe plans of care and anticipating patient care needs. Demonstrates ability to perform a wide range of Utilization Management/Quality Management/Performance Improvement (UM/QM/PI) activities that impact patient care and organizational outcomes. Reviews, analyzes and applies existing internal and external regulatory standards, and Professional Organization Guidelines. Develops measurement tools and pulls reports, which assist in efficient and accurate data collection. Uses a systematic approach to gather and evaluate data and patterns of utilization regarding quality of care issues to improve outcomes consistent with the organization's goals and objectives. Performs chart reviews, focused studies as assigned, duties in an independent manner with little or no direct supervision. Serves as a consultant on Utilization Management and Performance Improvement Initiatives. Assists with the organization's meeting of Utilization Management performance measures, by providing management, with educational sessions as needed, collecting data for focused evaluations and process improvement teams, preparing data analysis and reports for assigned committees at least quarterly. Performs at least two Utilization Management in-services/workshops annually, arranging for and conducting in-service education to physician staff regarding content of the educational sessions. Triage patient care to a level of clinical appropriateness based on InterQual. Researches, interprets, identifies, develops and presents formal and informal educational programs for health professionals and support services that include (New Employee Orientation, Nursing Orientation, Resident Orientation etc.) regarding UM. Establishes effective collegial relationships with appropriate professional organizations in the larger health care community on a local, state and national basis. Demonstrates thorough knowledge of InterQual criteria and their application. Collaborates with the Interdisciplinary Team and Hospitalist (PUMA). Collaborates admissions as an admission screening nurse. Able to verbalize process of admission. Demonstrates proficiency in the National Utilization Management Integration (NUMI) web-based application and Bed Management Solution (BMS) web-based tool for tracking bed availability, patient movement and flow management. Responsible for reviewing all inpatient cases after admission, conducting continued stay reviews 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: Full-time, Monday-Friday 8:00am-4:30pm. 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: 3 years of Inpatient Nursing experience 1 year of Utilization Management 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: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. This position requires the ability to lift 35- 50lbs. Transferring patients and objects may be required. Work requires the ability to physically intervene with disruptive patient/Veteran and protect self and others from injury using the knowledge gained from training.

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 Beckley VA Medical Center 200 Veterans Avenue Beckley, WV 25801 US
• Name: Amelia Rusk
• Phone: 254-922-6999
• Email: [email protected]