Registered Nurse (Utilization Management)

Department of Veterans Affairs • Salt Lake City, UT

37d • Onsite

About The Position

The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex utilization processes. Practical experience in the application of UM methods and expertise in medical necessity review criteria. This position requires strong analytical skills and the ability to evaluate program structure, process, and effectiveness and recommend strategies for program improvement. A Career At VA Salt Lake City Health Care System Can Take You Places (youtube.com)

Requirements

• Licensure: 1 full and unrestricted license from any US State or territory

Responsibilities

• Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization management program.
• Performs admission and continued stay reviews utilizing the InterQual Criteria for inpatients at the VA Salt Lake City Health Care System.
• Educates physicians, residents, interns, medical and nursing staff on documentation requirements necessary to meet InterQual criteria.
• Assists in quality improvement activities including data collection, data tracking, report formation, and participation on improvement teams.
• Possess a strong clinical knowledge of a range of adult to geriatric diseases. The knowledge base is preferred in Medicine, Surgery and/or Psychiatry.
• Performs analysis of Joint Commission, Office of Inspector General (OIG), VISN, and VHA Office of Quality, Safety and Value (QSV) - Utilization and Efficiency Management standards. Identifies those standards pertinent to utilization management and to alert facility leaders to potential vulnerabilities.
• Able to work in a fast paced, changing environment.
• Self-directed in goal setting.
• Identifies and escalate quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet patient healthcare needs.
• Position requires proficiency with computer skills which includes navigating the electronic medical record and keyboarding.
• Effective communication skills, both verbal and written.
• Other duties as assigned.

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)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Administration of Human Resource Programs
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees