Registered Nurse - ED, Utilization Management (Float)
The UM/Hospitalist RN is an integral member of the Interdisciplinary Team (IDT), and their objective is to focus on maximizing inpatient throughput by promoting collaboration across Utilization Management, Social Work, Hospitalist, inpatient nursing, pharmacy, and other interdisciplinary team members in order to enhance communication and break down barriers to Patients being placed at the right level of care at the right time, upon admission. The ER/Hospitalist UM RN promotes efficient, high quality patient care and cost-effective outcomes by reviewing documentation of medical services (requests and services being provided) against evidence-based McKesson InterQual criteria and educating providers regarding review outcomes and the national clinical guidelines being used. The ER/Hospitalist Utilization Management (UM) RN is responsible for providing the clinical expertise and leadership for implementation of the medical center's UM Program. He/she possesses intimate knowledge of standardized criteria for review, utilization management and review processes and principles, clinical documentation requirements, current standards of care, process improvement methods and compliance guidelines. The ER/Hospitalist UM RN is there to educate and guide and ensure that patients are placed at the right level of care at the right time, at the time of admission. The ER/Hospitalist UM RN partners closely with Social Work to improve coordination of care in preparation of timely and successful discharge to assure the patients' needs are met. He/she assists in the creation of process improvement projects to improve the UM processes and data. He/she serves as a liaison with inpatient and outpatient teams at time of admission to enhance a smooth transition to the right level of care. The ER/Hospitalist UM RN will successfully complete InterQual reviews as outlined by national directive and facility policy and assigned on his/her workload. The UM RN will provide recommendations on cost effectiveness and efficiency of programs based on InterQual review data aggregation. The ER/Hospitalist UM nurse will ensure that pre-screening and admissions reviews are completed timely as assigned and entered in the National Utilization Management Integration (NUMI) application. He/she will be responsible for analysis and process improvement projects to improve metrics associated with UM, especially in the emergency room. The ER/Hospitalist UM RN also provides backup coverage for other UM needs in other areas when appropriate as deemed necessary by the UM Manager. Please Note:
this is not to suggest that the only reviews to be done from this area are pre-admission/scheduled admissions reviews. The workload would need to be determined by the UM Nurse Manager. The position also requires the ability to work independently in accomplishing assignments, program goals, and objectives. The nurse in this position provides leadership for and participation in analyzing performance improvement activities. He/she serves to assist the Nurse Manager in gathering clinical and/or administrative data and in performing or making recommendation for UM generated reports and peer review. Work Schedule:
9:
00 a.m. to 5:
30 p.m. Monday to Friday Financial Disclosure Report:
Not required Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements:
United States Citizenship:
Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency. In accordance with 38 U.S.C. 7402(d), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Graduate of a school of professional nursing approved by the appropriate State-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant:
The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (Reference VA Handbook 5005, Appendix G6) OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing. Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Preferred
Experience:
Master's Degree 2-3 years of utilization management experience Collaborate effectively within a team Experience in emergency room as a Registered Nurse Knowledge of performance improvement projects and data usage Case Manager/Care Coordinator experience Grade Determinations:
The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade:
Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required. Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience. Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience. Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required. Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 year's of nursing practice/experience; OR a Doctoral degree and approximately 2-3 year's of nursing practice/experience. Reference:
VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements:
Moderate lifting; 15-44 pounds; Moderate carrying; 15-44 pounds; Reaching above shoulder; Use of fingers; Both hands required; Walking (8-12 hours); Standing (8-12 hours); Near vision correctable at 13 to 16 to Jaeger 1 to 4; Far vision correctable in one eye to 20/20 and to 20/40 in the other; Both eyes required; Ability to distinguish basic colors; Hearing (aid permitted).
Estimated Salary: $20 to $28 per hour based on qualifications.
this is not to suggest that the only reviews to be done from this area are pre-admission/scheduled admissions reviews. The workload would need to be determined by the UM Nurse Manager. The position also requires the ability to work independently in accomplishing assignments, program goals, and objectives. The nurse in this position provides leadership for and participation in analyzing performance improvement activities. He/she serves to assist the Nurse Manager in gathering clinical and/or administrative data and in performing or making recommendation for UM generated reports and peer review. Work Schedule:
9:
00 a.m. to 5:
30 p.m. Monday to Friday Financial Disclosure Report:
Not required Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements:
United States Citizenship:
Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency. In accordance with 38 U.S.C. 7402(d), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Graduate of a school of professional nursing approved by the appropriate State-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant:
The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (Reference VA Handbook 5005, Appendix G6) OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing. Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Preferred
Experience:
Master's Degree 2-3 years of utilization management experience Collaborate effectively within a team Experience in emergency room as a Registered Nurse Knowledge of performance improvement projects and data usage Case Manager/Care Coordinator experience Grade Determinations:
The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade:
Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required. Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience. Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience. Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required. Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 year's of nursing practice/experience; OR a Doctoral degree and approximately 2-3 year's of nursing practice/experience. Reference:
VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements:
Moderate lifting; 15-44 pounds; Moderate carrying; 15-44 pounds; Reaching above shoulder; Use of fingers; Both hands required; Walking (8-12 hours); Standing (8-12 hours); Near vision correctable at 13 to 16 to Jaeger 1 to 4; Far vision correctable in one eye to 20/20 and to 20/40 in the other; Both eyes required; Ability to distinguish basic colors; Hearing (aid permitted).
- Department:
0610 Nurse - Salary Range:
$56,330 to $130,541 per year
Estimated Salary: $20 to $28 per hour based on qualifications.
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