Registered Nurse-Nurse Manager-Utilization Management & Clinical Documentation Integrity

Summary

The RN-Nurse Manager-Utilization Management & Clinical Documentation Integrity will be an experienced nurse leader who ensures that Veteran-centered health care is provided and delivered in a quality - timely - accessible and respectful manner - consistent with the mission - goals - and objectives of the Veteran's Health Administration. Assume responsibility for the coordination of care focused on patient education - self-management - and customer satisfaction throughout the continuum of care.

Qualifications

Basic Requirements:

• English Language Proficiency: In accordance with 38 U.S.C. 7403(f) - 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 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
• Upon achievement of a State license - the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program
• (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 to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program
• Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD)
• 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
• Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements - but do not possess the required licensure - may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification
• 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
• An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I - Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required
• Nurse I - Level III Demonstrates proficiency in practice based on conscious and deliberate planning
• Self-directed in goal setting for managing complex client situations
• An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I - Level 2
• OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I - Level 2
• OR a Master's degree in nursing (MSN) and no additional professional nursing experience
• OR a Master's degree in a *related field with a BSN and no additional professional nursing experience
• Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• A BSN with 2 years of professional nursing equivalent to Nurse I - Level 3
• OR an MSN with one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Doctoral degree in Nursing with no professional nursing experience
• OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience
• Nurse III Executes position responsibilities that demonstrate leadership - experience and creative approaches to management of complex client care beyond the immediate practice setting
• MSN and 2 years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Master's degree in *related field with BSN and two years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• *Note: Foreign education programs/degrees are not creditable as related degrees
• Preferred Experience: -Able to communicate effectively with internal and external customers -2-5 years recent Utilization Management experience -2-5 years recent Clinical Documentation Improvement experience -Experience with InterQual Criteria -2-3 years experience managing teams and/or programs Reference: For more information on this qualification standard - please visit
• Pre-Employment/Post-Employment Physical Examination: May be required - depending on the needs of the organization
• Physical Requirements: A pre-placement examination will be required to be able to determine if the incumbent is able to safely operate a government vehicle
• The following requirements must be met: -distant vision 20/40 in one eye with or without correction - -field of vision 70 degrees - -ability to distinguish red - green - and amber - -whispered voice at five feet - or average hearing loss of not greater than 40 dbs
• at 500 - 1000 and 2 -000 Hz.

Duties

• As the Nurse Manager for Utilization Management & Clinical Documentation Integrity - in the Office of Quality and Patient Safety (OQPS) you will be responsible for a full range of duties - serving as the expert to oversee the operations of the assigned areas and demonstrate mastery in leading the nursing team
• Responsible for the 24-hour planning - organizing - and directing of activities for Clinical Documentation Improvement Educators - Utilization Management - Quality Clinical Documentation Improvement - and Registered Nurse Program Manager
• As a nursing leader - you will manage resources effectively to improve overall patient outcomes by serving as an active member of the interdisciplinary team and interacting with patients - family members - professionals - and supportive personnel in coordinating care
• Responsible to ensure and improve hospital throughput through all services in the facility
• Responsible to create/improve processes across all areas of responsibility as well as ensure patients meet the criteria for hospitalization and timely discharges when they are no longer acute
• You will be responsible for assessing the educational needs of the staff and collaborate to assure that learning needs are met
• Apply evidence-based practice principles to validate and or improve nursing practice
• Remove barriers through active collaboration with Nurse Executives - Nursing Supervisors - providers - site managers - and support services
• Duties include but are not limited to: Facilitate an atmosphere of interactive management and the development of collegial relationships among nursing personnel and other team members
• Promote a Just Culture environment in building a climate for effective performance while allocating available resources to promote safe - efficient - effective - and quality nursing/patient care
• Observe and evaluate the quality of nursing care provided including interdisciplinary patient rounds - review nursing documentation in clinical records - and collect - review - and analyze data related to the delivery of patient care
• Assure the compliance with all regulatory agencies and standards of practice and implementation of required actions to meet Performance Measures
• Provide leadership in the application of the nursing process to patient care - organizational processes and systems - and improve outcomes at the program or service level
• Provide leadership in identifying and addressing ethical issues with patients and staff - including initiating and participating in ethical consultations
• Initiate interdisciplinary projects to improve organizational performance
• Implement an educational plan to meet changing programs or service needs for self and others
• Maintain knowledge of current techniques - trends and professional issues
• Coach colleagues in team building
• Contribute to the strategic planning process - day-to-day operations - and attainment of goals of the organization
• Ability to provide direct patient care to an assigned group of patients as needed
• Participation in Medical Center committees to improve nursing practice and patient care
• Utilize advanced clinical knowledge/judgment to promote staff involvement in planning - decision-making - and evaluating outcomes
• Develop and manage collaborative partnerships union partners - physicians and other members of the interdisciplinary team
• Evaluate the performance of subordinates
• Other duties as assigned 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: Full-time
• Monday-Friday
• 7:00am-4:00pm Telework: Available
• Ad-hoc Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized **NOTE: Upon assignment to this position - the incumbent's salary will include two additional steps for assignment to a Head Nurse/Nurse Manager position.

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The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,321 health care facilities, including 172 VA Medical Centers and 1,138 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program. VHA Medical Centers provide a wide range of services including traditional hospital-based services such as surgery, critical care, mental health, orthopedics, pharmacy, radiology and physical therapy. In addition, most of our medical centers offer additional medical and surgical specialty services including audiology & speech pathology, dermatology, dental, geriatrics, neurology, oncology, podiatry, prosthetics, urology, and vision care. Some medical centers also offer advanced services such as organ transplants and plastic surgery.

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