Registered Nurse, Utilization Mgmt

Job Title

Utilization Management Registered Nurse

Duties

Delivers fundamental knowledge-based care to assigned clients while developing technical skills. Assesses, plans, implements, and evaluates care based on age-specific components. Assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care. Follows procedures per established policies and guidelines. Influences care outcomes by collaborating with members of the interdisciplinary team. Collects, monitors, interprets and communicates pertinent clinical data, applies InterQual criteria and enters information into a national database as required.

The Utilization Management (UM) RN demonstrates a high level of clinical practice, knowledge, and leadership skills to improve patient access, flow, and positively impact the facility utilization of services. The UM RN will be aligned within Patient Business Service and must work independently in accomplishing assignments and program goals. He/she possesses knowledge of utilization review criteria, UM processes and principles, clinical documentation requirements, current standards of care and compliance guidelines. As a clinical reviewer he/she serves as the QM liaison creating effective lines of communication with medical center leadership, staff, and internal/external customers. He/she collects, interprets and communicates pertinent clinical data, applies InterQual criteria and enters information into a National database.

Benefits

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: 06:30am to 3:00pm Monday - Friday

Telework: Ad-hoc

Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: Not Authorized

Permanent Change of Station (PCS): Not Authorized

Financial Disclosure Report: Not required