Utilization Management Nurse

Job TitleDuties include but are not limited to:Strong analytical skills and the ability to evaluate program structure, process, and effectiveness while recommending strategies for program improvement.Reviews inpatient charts, using third party criteria (currently InterQual), and collaborates with providers and an interdisciplinary team to provide recommendations and consultation. May refer specific cases to the Physician Utilization Management Advisors (PUMA).Excellent fact finding, interpersonal communication, and problem solving skills.Guides performance improvement projects and initiatives.Provides guidance regarding the best use of limited resources in a quality health care environment.Completes annual criteria training and testing requirements.Collaborates with the interdisciplinary team to coordinate safe and effective dischargesCompletes tasks necessary in preparation for discharge for example, following required DME, home services, outpatient needs, patient/family plans for discharge, and acting as a liaison between hospital staff and outside facilities.Collaborates with patients, family and/or caregivers, and healthcare professionals involved in their care.Coordinates discharge plan with providers, social work, ancillary services, and patient care nurses/units.Has a proactive approach to reduce readmissions, length of stay, and promotes a smooth transition from the hospital to another care setting. Includes early identification and assessment to determine barriers to discharge and discharge needs.VA offers a comprehensive total rewards package: VA Nurse Total RewardsPay: Competitive salary, regular salary increases, potential for performance awardsPaid 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 VAInsurance: 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 territoryWork Schedule: Full-time. Some weekend and weekday coverage required. 10:30 a.m. - 7:00 p.m. (There may be flexibility on weekend schedule)Compressed/Flexible: May be authorized.Telework: Not Available.Virtual: This is not a virtual position.Relocation/Recruitment Incentives: Not authorized.Permanent Change of Station (PCS): Not authorized.