Registered Nurse - Social Work (Utilization Management)

The Utilization Management (UM) Registered Nurse (RN) is responsible for providing competent, evidence-based practices within the position. Uses UM Criteria to perform complicated reviews. The UM RN activities include collecting, analyzing, and reporting data, creating, and providing provider education to a variety of providers, collaborating on ordered level of care and treatments plans, and conducting lnterQual reviews on prospective, observation, admission, and continued stay patients.

The Utilization Management (UM) Registered Nurse (RN) is responsible for providing competent, evidence-based practices within the position. Uses UM Criteria to perform complicated reviews. The UM RN activities include collecting, analyzing, and reporting data, creating, and providing provider education to a variety of providers, collaborating on ordered level of care and treatments plans, and conducting lnterQual reviews on prospective, observation, admission, and continued stay patients. Responsible for creating and providing education and guidance to internal and external customers of varying education levels on admission and continued stay criteria and best clinical documentation and utilization management practices to ensure efficient resource utilization. The individual may assist in directing the provision of nursing education, orientation, competencies and providing quality improvement and outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others on the acute care team. The nurse is a proficient nurse who demonstrates proficiency in decision-making and using the nursing process for complex situations that affect performance outcomes at the point of care. Practice is enhanced through development of collegial relationships. The nurse demonstrates collaboration by using the group process to solve problems and impact Veterans in acute care. The focus is on leadership in strategically planning long-term goals for the UM microsystem that impacts operations or resources. The proficient UM nurse demonstrates critical thinking with efficiency and accuracy in assessing and managing situations. VA offers a comprehensive total rewards package: VA Nurse Total Rewards 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: 14:00-21:30pm Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Must pass pre-employment physical evaluation. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). You may be required to serve a probationary period. Complete all application requirements detailed in the "Required Documents" section of this announcement.