Registered Nurse, Utilization Management Specialist

Job Summary

This position is located within the GEC Utilization Management, Nursing Service at the Phoenix VA Healthcare System in Phoenix, AZ.

Responsibilities

• The Utilization Management Registered Nurse at the PVAHCS plays a pivotal role in ensuring optimal patient care through admission and continued stay reviews for inpatients.
• With the use of National Utilization Management Integration software package in conjunction with VHA and local facility guidelines using evidence-based clinical decision-making tool.
• The nurse identifies the most appropriate level of care tailored to each patient's individual needs by thoroughly analyzing the patient's medical record and aligning it with InterQual criteria.
• The UM nurse is an active participant in daily team huddles and PVAHCS patient flow process initiatives, fostering interdisciplinary collaboration to enhance patient outcomes.
• The nurse provides timely and constructive feedback to the healthcare team regarding clinically appropriate care and alternative treatment options, contributing to a culture of continuous improvement and high-quality care delivery.
• The UM nurse possesses an in-depth understanding of InterQual criteria, utilization management processes, clinical documentation standards, and compliance regulations, demonstrating accountability in applying critical thinking and sound judgment to achieve favorable patient outcomes.
• The nurse exhibits a commitment to evidence-based practice principles, ensuring that care decisions are grounded in the latest clinical research and standards of care, ultimately enhancing the overall effectiveness of the healthcare system at PVAHCS.

Benefits

• 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)
• 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: 7:30am - 4:00pm, Weekends & Holidays
• Telework: Not Available
• Virtual: This is not a virtual position

Requirements

• U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment.
• Applicants who refuse to be tested will be denied employment with VA.
• Selective Service Registration is required for males born after 12/31/1959.
• You may be required to serve a probationary period.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process.
• Must pass pre-employment physical examination.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details.

Qualifications

• English Language Proficiency.
• Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited 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); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program.
• 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

• Utilization Management experience preferred

Grade Determinations

The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade.

The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment:

Grade/Level Scope Education Nurse I, Level I Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies. An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required.

Nurse I, Level II Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex.

Nurse I, Level III Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations.

Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others.

Nurse III Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting.

*Note: Foreign education programs/degrees are not creditable as related degrees

Reference: For more information on this qualification standard, please visit

Physical Requirements

Heavy lifting (45 lbs and over); Heavy carrying (45 lbs and over); Straight pulling and pushing; reaching above shoulder; use of fingers; both hands required; walking and standing up to 8 hours; repeated bending; Ability for rapid mental and muscular coordination simultaneously; hearing aid permitted.

Education Additional Information This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status.

VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority.

Pursuant to VHA Directive , VHA health care personnel (HCP) are required to be fully vaccinated against COVID-19 subject to such accommodations as required by law (i.e., medical, religious or pregnancy).

VHA HCPs do not include remote workers who only infrequently enter VHA locations. If selected, you will be required to be fully vaccinated against COVID-19 and submit documentation of proof of vaccination before your start date.

The agency will provide additional information regarding what information or documentation will be needed and how you can request a legally required accommodation from this requirement using the reasonable accommodation process.

If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.

Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer.

For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.