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Job Title: Nurse (Utilization Management - Clinical Command Center)
Company Name: Veterans Affairs, Veterans Health Administration
Location: Richmond, VA
Position Type: Full Time
Post Date: 09/12/2018
Expire Date: 11/11/2018
Job Categories: Finance/Economics, Healthcare, Practitioner and Technician, Human Resources, Information Technology, Military, Medical, Writing/Authoring
Job Description
Nurse (Utilization Management - Clinical Command Center)

The incumbent must possess thorough knowledge of Interqual review criteria, utilization management processes and principles, clinical documentation requirements, current standards of care, and compliance guidelines.

  • Utilizes critical thinking skills and sound judgment to ensure positive outcomes, maximize effective hospital resource utilization, while ensuring quality patient care services.
  • Provides leadership for and participates in performance improvement activities, interacting with a wide variety of employees and working independently to accomplish assignments and program goals.
  • Conducts and analyzes screening and reviews of patients including preadmission screening, admission reviews, continued stay reviews and occurrence screening reviews.
  • Takes an active role in the UM committee and participates in VISN and National Calls regarding the UM processes and updates.
  • Occasionally travels to community facilities to review and analyze data.
Work schedule: Monday - Friday, 12:00 Noon - 8:30 PM
Salary: Applicant's education and length of nursing practice (experience) will be considered by a Nurse Professional Standards Board in determining the grade and step of the applicant selected. Salary to be determined by a Nurse Professional Standards board based upon qualifications and experience.
Fair Labor Standards Act (FLSA) Status: Exempt
Supervisory Position: No.
Bargaining Unit Position: No
Recruitment/relocation incentives: May be authorized.
Relocation expenses: Not authorized.
Financial Disclosure Requirement: Not required.
Compressed/Flexible Schedule: Not authorized.
Telework: Not authorized.
Virtual: Not authorized.Basic Requirements:
  • United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
  • Graduate of a school of professional nursing approved by the appropriate State-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). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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.
  • 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.
Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade.

Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required.
Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience.
Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience.
Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 years of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 years of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required.
Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 years of nursing practice/experience; OR a Doctoral degree.

Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office.

Preferred Experience: At least 2 - 3 years of experience in complex nursing practices, with evidence of self-direction, Utilization Management activities and programs. Experience in InterQual guidelines is highly desirable.

Physical Requirements: The physical requirements of this position include lifting, prolonged standing and sitting, frequent bending, walking (distance), climbing, reaching (overhead, extensive/repetitive), repetitive motion and stooping. The mental/sensory requirements include recall, reasoning, problem-solving, hearing, speaking clearly, writing legibly, keyboarding, reading and logical thinking. The environment's pace can vary from steady to a sometimes-fast pace requiring handling of multiple priorities, frequent, sometimes intense customer interactions, and the ability to adapt to frequent changes in a sometimes-noisy environment. There may be the need to use personal protective equipment to prevent exposure to disease, illness and hazardous materials.

English Language Proficiency: Must be proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d).

None

To apply for this position, you must provide a complete Application Package which includes:

  • CV or Resume (required)
  • VA Form 10-2850a - Application for Nurse and Nurse Anesthetist
  • Candidates should provide copies of two (2) most recent annual proficiency reports or performance evaluations.
  • If currently employed in the VA system, include latest SF-50 - Notification of Personnel Action. (required).
  • Responses to the Occupational Questionnaire (required).
  • If prior military service, include all copies of your DD Forms 214 or proof of service (required). Applicants claiming preference based on service-connected disability, or based on being the spouse or mother of a disabled or deceased Veteran, must also complete and submit an SF 15, Application for 10-Point Veteran Preference (available at http://www.opm.gov/forms/pdf_fill/SF15.pdf).
  • Copies of official college transcript(s).
  • Copies of all licenses and specialty board certifications.
VA Form 10-2850a - Application for Nurses and Nurse Anesthetists can be found at: http://www.va.gov/vaforms/search_action.asp?FormNo=2850&tkey=&Action=Search.
Qualifications & Requirements
Basic Requirements:
  • United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
  • Graduate of a school of professional nursing approved by the appropriate State-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). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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.
  • 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.
Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade.

Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required.
Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience.
Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience.
Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 years of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 years of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required.
Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 years of nursing practice/experience; OR a Doctoral degree.

Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office.

Preferred Experience: At least 2 - 3 years of experience in complex nursing practices, with evidence of self-direction, Utilization Management activities and programs. Experience in InterQual guidelines is highly desirable.

Physical Requirements: The physical requirements of this position include lifting, prolonged standing and sitting, frequent bending, walking (distance), climbing, reaching (overhead, extensive/repetitive), repetitive motion and stooping. The mental/sensory requirements include recall, reasoning, problem-solving, hearing, speaking clearly, writing legibly, keyboarding, reading and logical thinking. The environment's pace can vary from steady to a sometimes-fast pace requiring handling of multiple priorities, frequent, sometimes intense customer interactions, and the ability to adapt to frequent changes in a sometimes-noisy environment. There may be the need to use personal protective equipment to prevent exposure to disease, illness and hazardous materials.

English Language Proficiency: Must be proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d).
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Contact Information
Contact Name:
Company Name: Veterans Affairs, Veterans Health Administration
Phone Number:
Fax Number:
Contact Email:Patty.Davis5@va.gov
Website:http://www.ecentralmetrics.com/url/?u=252911021455%2D254&r=http%3A%2F%2Fwww%2Evacareers%2Eva%2Egov%2Fjob%2Dsearch%2Fjob%2Ddetail%2Easp%3Fjob%3D349608
Company Description:

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