Job Listing
Utilization Management Registered Nurse
Veterans Health Administration · Posted 6 days ago
About the Role
The Albuquerque VA is looking for Utilization Management Registered Nurse for Care Coordination in Operations Service!
What You'll Do
- →The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization processes.
- →Practical experience in the application of UM methods and expertise in medical necessity review criteria.
- →This position requires strong analytical skills and the ability to evaluate program structure, process, and effectiveness and recommend strategies for program improvement.
- →The UM RN is responsible for participating in field UM program review activities and providing advanced clinical and administrative recommendations and consultation to local and VISN UM staff.
- →Possesses comprehensive knowledge of clinical appropriateness, functions, processes, and principles of utilization management.
- →They must have strong interpersonal communication skills to instruct UM staff in medical necessity criteria and interact with all levels of clinical and administrative leadership across the facility.
- →They possess excellent fact-finding and problem-solving skills, including familiarity with statistical analysis and nonparametric data.
- →They have advanced knowledge in the utilization management and workload data sources available and serves as a resource to help UM programs analyze and display UM outcomes to highlight quality and efficiency improvement opportunities.
- →They are experienced in performance improvement and/or systems redesign methodology and use this knowledge to guide system improvement in process and resource use at the local and network level.
- →They must have a successful track record of successfully managing multiple priorities while maintaining a focus on quality and detail.
- →Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized
Requirements
- ✓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.
- ✓Subject to background/security investigation.
- ✓Selected applicants will be required to complete an online onboarding process.
- ✓Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents).
- ✓Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
- ✓Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
- ✓As a condition of employment for accepting this position, you will be required to serve a 2-year probationary period during which we will evaluate your fitness and whether your continued employment advances the public interest.
- ✓In determining if your employment advances the public interest, we may consider: Your performance and conduct; The needs and interests of the agency; Whether your continued employment would advance organizational goals of the agency or the Government; and whether your continued employment would advance the efficiency of the Federal service.
- ✓Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
- ✓Complete all application requirements detailed in the "Required Documents" section of this announcement.
Personality Fit
Job ID: e6384f13-186e-4a28-ba40-7e0987978fee
Posted via USAJobs