***Open to First 50 Applicants*** The RN Clinical Reviewer is a Registered Nurse, qualified by education and experience to provide direct support to the Office of Finance 104P Payment Operations in planning, designing, integrating, implementing, modifying, and evaluating the effectiveness of program components and/or services to improve the quality of patient care and the appropriateness and timeliness of services provided.

Duties

This announcement will close on , the first 50 applications received will receive first consideration. Applications that are submitted after 11:59 p.m. Eastern Time on the date in which the initial cut-off number has been reached will not receive consideration unless otherwise requested by management. VA offers a comprehensive total rewards package: VA Nurse Total Rewards The Clinical Nurse Reviewer (CNR) has a broad knowledge of nursing clinical practice, review techniques, program evaluation, preauthorization criteria, and standards of care. The RN Clinical Reviewer is responsible for providing the clinical leadership and expertise for the coordination of Payment Operations in Finance. RN Clinical Reviewer functional role includes organizing and coordinating the clinical components for the authorization of Payment Operations in response to individual health care needs along the illness and care continuum and in multiple settings. Performs clinical adjudication of emergency care claims. The RN Clinical Reviewer utilizes all avenues of resources available to provide safe and efficient timely coordination of quality health care and services. Reviews clinically denied care with notice of disagreements to determine payment. Coordinates the payment for overturned appeals from VISN or Board of Veteran Appeals. Scope of Nurse I/Level 3: Demonstrates proficiency in practice based on conscious, deliberate planning. Self-directed in goal setting for managing complex patient situations (VA Handbook 5005, Part II, Appendix G6). The Nurse I/Level 3 registered nurse is a competent nurse who demonstrates competence in practice and decision-making, deliberate planning, and critical thinking skills. The competent nurse evaluates, coaches, mentors, and demonstrates leadership skills through collaborative efforts. 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: Monday - Friday; TOD to be set based on organizational need Compressed/Flexible: considered after training Telework: Authorized Virtual: This is a virtual position within 50 miles of Cleveland, OH or Largo, FL 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: 10 years nursing experience over all; 5 years of clinical experience in ED, ICU, Triage, case management, and care management. 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: Long periods of sitting in one location are required in completing transactions, using a computer with dual monitors as well as other standard office equipment.

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 VHA Servicing Human Resources Office - 2 2402 Wildwood Ave Suite 301 Sherwood, AR 72120 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]