Registered Nurse - Social Work (Utilization Management)

Veterans Health Administration • Tucson, AZ

11d • Onsite

About The Position

The Utilization Management Registered Nurse provides competent, evidence-based nursing practice and uses utilization management criteria to conduct complex reviews. The role involves collecting, analyzing, and reporting data; developing and delivering education to internal and external providers; collaborating on ordered levels of care and treatment plans; and conducting InterQual reviews for prospective, observation, admission, and continued-stay patients.

The nurse provides education and guidance on admission and continued-stay criteria, clinical documentation, and utilization management practices to support efficient resource utilization. The position may assist with nursing education, orientation, competencies, quality improvement, and outcomes-utilization consultation. It also involves collaborative leadership in holistic acute care, proficient decision-making in complex situations, strategic planning for long-term utilization management goals, and critical thinking in assessing and managing situations.

The position has a work schedule of 14:00–21:30. Telework and virtual work are not available. Relocation and recruitment incentives, as well as permanent change of station authorization, are not offered. Physical duties may include walking, bending, stooping, lifting, extended sitting or standing, and transferring patients or objects. Safe patient-handling protocols and provided mechanical lifts are used.

Requirements

• Proficiency in basic written and spoken English.
• Graduation from an appropriately accredited school of professional nursing, or qualifying equivalent education as specified in the announcement.
• Current, full, active, and unrestricted registered nurse licensure in a U.S. state, territory, commonwealth, or the District of Columbia; a temporary Graduate Nurse Technician exception is described for eligible candidates pursuing licensure.
• Meet the education and professional nursing experience requirements for the assigned Nurse grade and level.
• Meet applicable grade-level dimensions, including practice, Veteran/patient-driven care, leadership, professional development, and evidence-based practice/research.
• Pass a pre-employment physical evaluation.
• Meet U.S. citizenship requirements, subject to the stated VA policy exception for non-citizens.
• Complete required background/security checks, onboarding, identification verification, and other application requirements.
• Register for Selective Service if applicable.
• Participate in the seasonal influenza vaccination program.

Nice To Haves

• Experience in utilization management.

Responsibilities

• Use utilization management criteria to perform complex reviews.
• Collect, analyze, and report data.
• Create and provide education to internal and external providers and customers on admission and continued-stay criteria, clinical documentation, and utilization management practices.
• Collaborate on ordered levels of care and treatment plans.
• Conduct InterQual reviews for prospective, observation, admission, and continued-stay patients.
• Assist with nursing education, orientation, competencies, quality improvement, and outcomes-utilization consultation as needed.
• Collaborate with the acute care team to deliver and improve holistic care.
• Strategically plan long-term goals for the utilization management microsystem that affect operations or resources.
• Assess and manage complex situations with critical thinking, efficiency, and accuracy.

Benefits

• Competitive salary and regular salary increases.
• Potential performance awards.
• 50 days of paid time off per year: 26 days annual leave, 13 days sick leave, and 11 paid federal holidays.
• Traditional federal pension with five-year vesting.
• 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: Mid Level
• Education Level: Associate degree