Nurse (Utilization Management)

Summary

The VA Portland Health Care System - in Portland - Oregon is hiring a Registered Nurse (RN) Utilization Management (UM) that executes position responsibilities which demonstrate leadership - experience - and creative approaches to management of complex utilization processes. This position requires strong analytical skills and the ability to evaluate program structure - process - and effectiveness and recommend strategies for program improvement.

Qualifications

Basic Requirements:

• English Language Proficiency
• In accordance with 38 U.S.C. 7403(f) - 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 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)
• OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program
• Upon achievement of a State license - the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program
• (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 to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program
• Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD)
• 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
• Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements - but do not possess the required licensure - may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification
• Grade Determinations: The following Scope - Education and Dimension criteria must be met in determining the grade assignment of candidates - and if appropriate - the level within a grade
• The Dimension requirements (Practice - Veteran/Patient Driven Care - Leadership - Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/12925271
• Grade/Level Scope Education Nurse I - Level I Delivers fundamental - knowledge-based care to assigned clients while developing technical competencies
• An Associate Degree (ADN) or Diploma in Nursing - with no additional professional nursing required
• Nurse I - Level II Demonstrates integration of biopsychosocial concepts - cognitive skills and technically competent practice in providing care to clients with basic or complex
• An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I - Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required
• Nurse I - Level III Demonstrates proficiency in practice based on conscious and deliberate planning
• Self-directed in goal setting for managing complex client situations
• An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I - Level 2
• OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I - Level 2
• OR a Master's degree in nursing (MSN) and no additional professional nursing experience
• OR a Master's degree in a *related field with a BSN and no additional professional nursing experience
• Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• A BSN with 2 years of professional nursing equivalent to Nurse I - Level 3
• OR an MSN with one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Doctoral degree in Nursing with no professional nursing experience
• OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience
• Nurse III Executes position responsibilities that demonstrate leadership - experience and creative approaches to management of complex client care beyond the immediate practice setting
• MSN and 2 years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Master's degree in *related field with BSN and two years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• *Note: Foreign education programs/degrees are not creditable as related degrees
• Preferred Experience: 5 years RN experience - Preferred Charge Nurse experience - Medical and Surgical care experience
• Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/
• Physical Requirements: Light lifting (under 15 pounds)
• Light carrying (under 15 pounds)
• Reaching above shoulder
• Use of fingers
• Both hands required
• Ability for rapid mental and muscular coordination simultaneously
• 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
• Ability to distinguish basic colors
• Hearing (aid may be permitted)
• Mental & emotional stability required
• Sit for majority of work day
• Environment Factors: Working closely with others
• Working alone.
  
  

Duties

• Portland is a port city in the Pacific Northwest and the most populous city in the U.S. state of Oregon
• Situated in the northwestern area of the state at the confluence of the Willamette and Columbia rivers
• Portland is known for having the amenities of a major city (such as an international airport - an efficient public transit system - major league sports teams and many museums and art galleries) and the charms of a small city (such as plentiful arts and crafts fairs - independent bookstores and local traditions like the annual Rose Festival Parade)
• Rain or shine - you can take advantage of the city's proximity to nature by playing in the Willamette River - wandering through lush public parks and gardens - biking the city's 162 miles (261 km) of bike lanes and hiking trails both within city limits and in the nearby Columbia River Gorge
• The Registered Nurse (RN) Utilization Management (UM) duties include - but not limited to: Responsible for participating in field UM program review activities and providing advanced clinical and administrative recommendations and consultation to local and the Veterans Integrated Service Network (VISN) UM staff
• Possesses comprehensive knowledge of clinical appropriateness - functions - processes - and principles of utilization management
• Encompasses 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
• Exercises excellent fact-finding and problem-solving skills - including familiarity with statistical analysis and nonparametric data
• Executes 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
• 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
• Accomplishes successful track records of successfully managing multiple priorities while maintaining a focus on quality and detail
• 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: Tuesday - Friday - 7:00am-5:30pm PST Compressed/Flexible: Yes
• Telework: Not available
• Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: Not authorized
• Permanent Change of Station (PCS): Not authorized.