The Central Texas VA Healthcare System is seeking a highly qualified Registered Nurse for the Utilization Management Practitioner position.

Duties

The Utilization Management Practitioner (UMP) Registered Nurse 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. The UMP will provide guidance within an enterprise risk management framework, driving improvement and developing processes which support safe and efficient patient care delivery. Achievement of these responsibilities will require strong skills in the leading of 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. The UMP must have knowledge of evaluation techniques and their application to the CTVHCS setting, including general knowledge of processes utilized in problem identification, prioritization, analyses, leading change, displaying data to facilitate understanding of potential/actual issues, translating data into information, research, data mining, and program evaluation. The UMP will possess thorough knowledge and competence of InterQual Evidence-based Clinical Content solution, management process, clinical documentation requirements, current standards of care, federal and regulatory requirements, and compliance guidelines for optimizing care management. 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. The UMP provides guided decision support for the transitioning of patients throughout the care patient flow 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. Assumes direct responsibility in the review and analysis of the facility length of stay, cost per case and utilization compliance on a continual basis. Provides support at the unit level, the service level, the organizational level, and work areas assigned to meet the needs of CTVHCS. Completes other assignments as delegated by the UM Nurse Manager. The UMP is responsible for coordinating, developing, executing, monitoring, and evaluating all UM activities. Activities encompass utilization review, resource management, coordination of care, transition/discharge planning, and across the board episodes of care. The UMP promotes and facilitate patient movement throughout the healthcare continuum with the development and implementation of processes and procedures that ensures timely and proactive guidance to case manager and social worker interventions. The UMP conducts UM Reviews assessments for appropriateness of admission, continued stay and to facilitate and expedite discharge of patients using established criteria. Facilitate 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. The UMP 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 the IDT other case managers and Utilization Management staff. 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: Rotating Shifts including weekends Telework: Available per Facility Policy 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: Evidence of Belt/Systems Redesign training/experience/certification SNT/GNT/RNTTP completion

Education

Note: Only education or degrees recognized by the appropriate State agency and accredited by either: a) The Accreditation Commission for Education in Nursing (ACEN); or b) The Commission on Collegiate Nursing Education (CCNE) or 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:

1. ACEN - http://www.acenursing.us/accreditedprograms/programSearch.htm
2. CCNE - https://www.aacnnursing.org/CCNE-Accreditation/CCNE-Accredited-Programs
3. U.S. Department of Education - 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.

Note: If your school was accredited by Accreditation Commission for Education in Nursing (ACEN) or Commission on Collegiate Nursing Education (CCNE) at the time of graduation but is no longer listed on the ACEN or CCNE website, you must provide documentation of accreditation with your application packet.

Note: If your school has changed names, or is no longer in existence, you must provide this information in your application.

Note: Failure to submit supporting documentation may disqualify you for further consideration on this announcement.

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]