Registered Nurse (Utilization Review) VN-0610-I-III
Department Of Veterans Affairs - Honolulu, HI

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Vacancy Identification Number (VIN): 611508 (Please include on all documents)

Areas of Consideration: 1st: The first area of consideration shall be any VISNs 18, 20, 21 and 22 impacted revenue/MCCF employees at the current duty location where the vacancies are filled; 2nd: The second area of consideration shall be other unit employees at their current duty location in VISNs 18, 20, 21 and 22 facilities where the vacancies are filled; 3rd: The third area of consideration will be facilitywide employees; 4th: VA wide employees, 5th: Other Status Eligibles, 6th: Public

Nurse salaries will be determined by the Nurses Professional Standards Board (NPSB)

Our mission: To fulfill President Lincoln's promise - "To care for him who shall have borne the battle, and for his widow, and his orphan" - by serving and honoring the men and women who are America's Veterans.

YOU CAN MAKE A DIFFERENCE

We are pleased to announce a dynamic and exciting opportunity available for an experienced Registered Nurse (Utilization Review) for the Consolidated Patient Accounts Center (CPAC) located in Honolulu, HI.

CPAC is a regionally consolidated business entity established to enhance resource operations throughout the VHA network by standardization and consolidation of functions, and the integration of VHA and industry best practices. The CPAC team provides revenue services for multiple medical centers, located within its assigned geographical area. CPAC is not part of the VA Medical Center.

Relocation expenses may be paid to a highly qualified candidate.

The Department of Veterans Affairs offer s Permanent Change of Station (PCS) relocation services. Permanent Change of Station is the relocation of a household due to government convenience in connection with a transfer between duty stations or facilities. For more information go to http://vaww.fscdirect.fsc.va.gov/pcs.asp .

KEY REQUIREMENTS

You must be a US citizen to apply for this job

Selectees are subject to fingerprint and background investigation.

Selectees may be subject to a one-year probationary/trial period.

More than one selection may be made from this announcement.

All requirements must be met by the closing date of this announcement.

Designated and/or random drug testing required.

DUTIES:
Responsibilities of the RUR (Registered Utilization Review) Nurse include but are not limited to:

Pre-certification, admission, concurrent, discharge, retrospective and appeals/denial reviews to obtain approval from third party payers for services provided to Veterans.

Uses advanced clinical knowledge and communication skills to efficiently and effectively perform the clinical review in CPRS and to contact the third party payer for authorization of services.

The RUR nurse is a patient advocate and program liaison and conducts focused reviews requiring clinical input for sensitive diagnosis, special consent issues, service-connected and special eligibility validation, as well as clinical reviews for tort feasor and workers compensation cases.

Reviews and conducts special eligibility validation reviews including SC, Agent Orange, Combat Vet, etc.

The RUR nurse collaborates with clinical staff to provide education, feedback, and assistance regarding documentation of medical necessity, insurance review criteria, and SC issues and d ocuments the results of the review in VISTA and Stockamp and coordinates continuity of care with facility revenue staff as needed.

Collaborates with the facility revenue staff for ROI documentation, and logs disclosure of ROI in the ROI package, or provides the necessary information to the ROI staff at the facility.

Actively participates in program development at the facility level and works to identify clinics that need to be added to the Stockamp High Dollar Clinic List.

Conducts SC reviews using Quadramed and also assists with clinical reviews as directed by the CBO: i.e., The Combat Vet Project.

The RUR nurse at the facility level performs reviews for their facility as well as provides support to other facilities within the CPAC.

QUALIFICATIONS REQUIRED:
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.

Required Experience :
  • Current or previous clinical experience.
  • Must be a graduate of a professional school of nursing approved by the appropriate State agency and accredited by the Nursing Accrediting Commission or the Commission on Collegiate Nursing Education.
  • Current full, active, and unrestricted license and registration from any State, Territory or Commonwealth of the United States, or the District of Columbia.
  • 38 U.S.C. 7402(d) and 7407(d) requires that persons appointed to direct patient-care positions must possess the required basic proficiency in spoken and written English.
  • Physical Requirement. Must be able to pass a pre-employment physical.
  • Documented skill in effective interpersonal relations and collaboration with interdisciplinary team members.
  • Documented skill in effective communication skills and professional behaviors that promote cooperation and teamwork with internal and external customers.
  • Documented skill in independent decision-making, sound clinical judgment and critical thinking abilities.
  • Documented knowledge of quality improvement issues related to the utilization of resources.
  • Documented evidence of dependability and reliability.
Nurse I, Level 1 Qualifications

Associate Degree or Diploma in Nursing

Nurse I, Level 2 Qualifications

Specialized experience: 1 year of specialized experience in nursing with a Associate Degree or Diploma in Nursing

OR

Associate Degree or Diploma in Nursing and Bachelors' degree in a related field

OR

Bachelor of Science in Nursing

Nurse I, Level 3 Qualifications

Specialized experience: 2-3 years of specialized experience in nursing with a Associate Degree or Diploma in Nursing

OR

Specialized experience: 1-2 years of specialized experience in nursing with a Associate Degree or Diploma in Nursing and Bachelors' degree in a related field.

OR

Specialized experience: 1-2 years of specialized experience in nursing with a Bachelors' degree in Nursing

OR

Master's degree in nursing or related field with BSN

Nurse II Qualifications

Specialized experience: 2-3 years of specialized experience in nursing with a BSN or Associate Degree or Diploma in Nursing and Bachelors' degree in a related field.

OR

Specialized experience: 1-2 years of specialized experience in nursing with Master's degree in nursing or related field with BSN.

OR

Education: Doctoral degree in nursing or meets basic requirements for appointment and has a doctoral degree in a related field.

Nurse III Qualifications

Specialized experience: 2-3 years of specialized experience in nursing with a Master's degree in nursing or related field with BSN.

OR

Education: Doctoral degree in nursing or related field.

Licensure : Current and unrestricted registration as a graduate professional nurse in a State, Territory, Commonwealth of the United States or the District of Columbia.

CONDITIONS OF EMPLOYMENT : (Failure to comply may be grounds for withdrawal of an offer of employment or dismissal after appointment)

  • Applicants must be citizens of the United States. Required English Language Proficiency
  • Applicants tentatively selected for certain designated positions may be subject to a random drug screening for illegal drug use. Applicants who refuse to be tested will be denied employment.
  • New Appointees will be subject to a background investigation to determine suitability. Male applicants born after December 31, 1959, must certify at the time of appointment that they have registered with the Selective Service system or are exempt for having to do so under Selective Service law.
  • Applicants must not be listed on the Department of Health and Human Services (DHHS) Office of Inspector General Sanctions database.
  • VET PRO: Selected candidate will be required to successfully complete a credential process before entering on duty. This process includes employment verification, personal history, education & license/registration/certification verification, and reference check. Selected candidate will be required to provide a certified copy of college transcript(s) and information on any licenses/certifications/or registrations currently or previously held.
Veterans: Must include a copy of Form DD-214 (Certificate of Discharge). 10 Pt preference-eligible should submit Form SF-15 (Application for 10 PT Veterans Preference) along with a letter (dated within the last 12 months) from the VA certifying percent of service-connected disability.

Additional information on the qualification requirements is outlined in the OPM Qualifications Standards Handbook of General Schedule Positions. It is available for your review on OPM's web site at http://www.opm.gov/qualifications/standards/indexes/alph-ndx.asp .

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.

APPLICANTS PLEASE NOTE: Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications (particularly positions with a positive education requirement.) Therefore, applicants must report only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Applicants can verify accreditation at the following website: http://www.ed.gov/admins/finaid/accred/index.html All education claimed by applicants will be verified by the appointing agency accordingly. *** If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. ***

Citizenship: Citizen of the United States.
Must be a graduate of a professional school of nursing approved by the appropriate State agency and accredited by the Nursing Accrediting Commission or the Commission on Collegiate Nursing Education.
Current full, active, and unrestricted license and registration from any State, Territory or Commonwealth of the United States, or the District of Columbia.
English Language Proficiency: Proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d)
Physical Requirement. Must be able to pass a pre-employment physical.

HOW YOU WILL BE EVALUATED:
Once the application process is complete, a review of your application will be made to ensure you meet the job requirements. Incomplete Applications will be disqualified and will receive no further consideration. Requests for reconsideration will not be considered for applicants who fail to submit a complete application package. We cannot be held responsible for delays in mail service, etc.

BENEFITS:
Working for the Department of Veterans Affairs offers a comprehensive benefits package that includes, in part, paid vacation, sick leave, holidays, life insurance, health benefits, and participation in the Federal Employees Retirement System. In addition to traditional "dollars and cents" benefits, we offer a range of benefits to help balance work and life. For more information please visit us at http://www4.va.gov/JOBS/Job_Benefits/benefits.asp .

OTHER INFORMATION:
The materials you send with your application will not be returned to you.

We cannot be held responsible for incompatible software, fax transmissions, delays in mail service.

Applications received in government pre-paid envelopes will not be considered

The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced Federal competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation and be found well-qualified (meets minimum qualifications, any selective factor and demonstrates ability to satisfactorily perform the duties of the position upon entry) for this vacancy. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website at http://www.opm.gov/ctap/index.asp .

Receiving Service Credit for Earning Annual (Vacation) Leave : Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. VA may offer newly-appointed Federal employees credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave.

S pecial Employment Consideration: Individuals eligible for the following appointments are encouraged to apply: 5 CFR 213.3102 "u", Schedule A, Appointment of persons with disabilities ; mental retardation, severe physical disabilities, or psychiatric disabilities; and Disabled veterans with a compensable service-connected disability of 30% or more.

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The United States Department of Veterans Affairs (VA) is a government-run military veteran benefit system with Cabinet-level status. It is...