Utilization Management Registered Nurse

The Albuquerque VA is looking for Utilization Management Registered Nurse for Care Coordination in Operations Service!

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. The UM RN is responsible for participating in field UM program review activities and providing advanced clinical and administrative recommendations and consultation to local and VISN UM staff.

Possesses comprehensive knowledge of clinical appropriateness, functions, processes, and principles of utilization management. They must have strong interpersonal communication skills to instruct UM staff in medical necessity criteria and interact with all levels of clinical and administrative leadership across the facility. They possess excellent fact-finding and problem-solving skills, including familiarity with statistical analysis and non-parametric data. They have advanced knowledge in the utilization management and workload data sources available and serves as a resource to help UM programs analyze and display UM outcomes to highlight quality and efficiency improvement opportunities.

They are experienced in performance improvement and/or systems redesign methodology and use this knowledge to guide system improvement in process and resource use at the local and network level. They must have a successful track record of successfully managing multiple priorities while maintaining a focus on quality and detail.

• 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:
  
  M-F (hours may vary)
• Telework:
  Not Available
• Virtual:
  This is not a virtual position.
• Relocation/Recruitment
  
  Incentives:
  
  Not Authorized
• Permanent Change of Station (PCS):
  Not Authorized