Nurse (Assistant Nurse Manager)

Veterans Health Administration • Orlando, FL

19d • Onsite

About The Position

The Revenue Utilization Review (RUR) Assistant Nurse Manager is accountable to the Consolidated Patient Account Center (CPAC) Director and RUR Nurse Manager. The role manages RUR Nurses and general schedule (GS) staff regionally across various states and the Commonwealth of the United States. It requires in-depth knowledge of service connection and special authority eligibility requirements, first- and third-party medical review criteria, nurse utilization review processes, clinical documentation requirements, current standards of care, and compliance guidelines.

The position provides leadership and oversight with substantial and continuous responsibility and accountability for population groups and integrated programs that cross service lines. The Assistant Nurse Manager is responsible for administrative functions of the assigned service-line staff and establishes and maintains effective relationships with personnel at all levels of the Health Care System. The role engages with customers, including VA Medical Center service lines in the assigned region, community providers, third-party payers, and local and national program leaders.

The position is not virtual or telework eligible. The employee must live within 50 miles of the Orlando Lakemont facility. The work schedule is 8:00 a.m.–4:30 p.m.

Requirements

• Be a U.S. citizen, subject to the stated exception under VA policy for non-citizens when qualified citizens cannot be recruited.
• Be proficient in basic written and spoken English.
• Graduate from an appropriately accredited school of professional nursing, or meet the stated nursing education alternative requirements.
• Hold current, full, active, and unrestricted professional nurse registration in a U.S. State, Territory, Commonwealth, or the District of Columbia, subject to the stated GNT exception.
• Live within 50 miles of the Orlando Lakemont facility.
• Pass a pre-employment physical evaluation or examination.
• Participate in the seasonal influenza vaccination program.
• Meet the applicable education, experience, and dimension criteria for the assigned Nurse grade and level.
• Possess in-depth knowledge of service connection and special authority eligibility requirements, first- and third-party medical review criteria, nurse utilization review processes, clinical documentation requirements, standards of care, and compliance guidelines.

Nice To Haves

• Five years of nursing experience and a strong clinical background.
• Three to four years of relevant case management or utilization review experience.
• InterQual experience.
• Case Management or Utilization Review certification.
• Knowledge and skill in applying CPT, ICD-10, and HCPCS coding.
• Ability to collaborate effectively and communicate across all areas of the revenue cycle.

Responsibilities

• Manage RUR Nurses and general schedule (GS) staff regionally across various states and the Commonwealth of the United States.
• Provide leadership and oversight for population groups and integrated programs that cross service lines.
• Perform administrative functions for assigned service-line staff.
• Establish and maintain effective relationships with Health Care System personnel at all levels.
• Engage with VA Medical Center service lines, community providers, third-party payers, and local and national program leaders.

Benefits

• Competitive salary, regular salary increases, and potential for performance awards.
• 50 days of paid time off per year: 26 days of annual leave, 13 days of sick leave, and 11 paid Federal holidays.
• Traditional federal pension with five-year vesting and federal 401(k), with up to 5% in contributions by VA.
• Federal health, vision, dental, term life, and long-term care insurance; many federal insurance programs can be carried into retirement.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Associate degree