The RN is responsible for utilizing evidence based InterQual criteria to conduct prospective, concurrent, and retrospective reviews using the National Utilization Management Integration database. The RN will work predominately in the emergency department to assess and collect health data based on this criteria and makes recommendations to the provider on the most appropriate level of care for the patient and determine if the patient meets medical necessity for the hospital stay. 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: Able to communicate effectively with internal and external customers 3-5 years recent Clinical Experience 2-5 years recent Interqual Experience Ability to analyze and compile data 2-3 years experience managing teams and/or programs 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 years of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 years 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 years of nursing practice/experience; OR a Doctoral degree and approximately 2-3 years of nursing practice/experience. Note regarding MSN degrees: If your MSN was obtained via a Bridge Program that qualifies for professional nursing registration, a BSN is not required. 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: The population of male and female Veterans served ranges from the adult, age 18, to the elderly adult, age 65 and over. South Texas Veterans Health Care System is a tertiary healthcare facility, providing acute medical, surgical, behavioral health, physical medicine and rehabilitation, geriatric, and primary care services predominately to Veterans, but in special cases, includes active-duty military and civilian populations. This position requires visual acuity, hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. Refer to Optional Form 178 dated April 2012 for additional functional requirements and environmental factors. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent may be exposed to infectious patients and/or contaminated materials that my require wearing of various levels of personal protective equipment (PPE) for long periods of time, caring for patients on isolation precautions, active participation in screening potentially infectious patients, and participating in labor pools during pandemics/disaster response situations the incumbent may be required to work in modified environments of care based on safety requirements and the needs of the patient. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, and be able to shift priorities based on patient needs. ["VA offers a comprehensive total rewards package: VA Nurse Total Rewards The RN Utilization Management position is at the VA in San Antonio. The RN is responsible for utilizing evidence based InterQual criteria to conduct prospective, concurrent, and retrospective reviews using the National Utilization Management Integration database. The RN will work predominately in the emergency department to assess and collect health data based on this criteria and makes recommendations to the provider on the most appropriate level of care for the patient and determine if the patient meets medical necessity for the hospital stay. Responsible for utilizing InterQual criteria and conducts InterQual reviews using the National Utilization Management Integration database, successfully passes the Inter-Rater reliability exams annually. Assesses and collects health data based on the InterQual criteria and communicates to an interdisciplinary team, developing plans for those patients not meeting InterQual Criteria and noting the right level of care. Monitors admission and continued stay criteria identifying potential process deficiencies, makes suggestions for improvement, and reports discrepancies through the appropriate chain of command. Interprets federal regulations, VHA guidelines, medical review criteria, utilization management processes, clinical documentation requirements, current standards of care, and compliance guidelines. Demonstrates leadership in delivering and improving holistic care for Veterans through collaborative, courteous, timely, patient centered communication with all medical disciplines within the South Texas Veterans Health Care System. Serves as a resource person and serve as a consultant for problem solving nursing and organizational issues. Identifies trends and develops actions plans and/or participates in service or organizational projects to improve services with measurable, sustainable outcomes. Participates in Nursing Service and medical facility committees. 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: Rotating Shifts, Rotating Day, Weekends, Holiday Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required"]
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.
