A recruitment/relocation incentive is not authorized for this position. Functions as a member of the Utilization Management (UM) Nurses team for Milwaukee VAMC. Utilization Management (UM) refers to a program aimed at increasing the efficiency and appropriateness with which services are provided and resources used while maintaining quality of care. The primary function of this position is conducting Admission (including Observation) and Continued Stay Reviews by the application of standardized evidenced based criteria to assure placement of patients at the most appropriate level of care. VHA uses Change Healthcare (formerly McKesson ®) InterQual criteria. The UM Nurse works closely with practitioners to assure appropriate patient placement/transition/discharge. The UM Nurse attends daily discharge planning meetings/bed huddles. The UM Nurse reviews all medicine admissions prior to placement. UM nurses may also be responsible for reviewing inpatient cases prior to admission, case management, and focused studies of utilization patterns. Acts as a facility consultant for UM issues. The UM Nurse is accountable for accurate and complete data collection as it relates to these responsibilities. Other major responsibilities include formulating recommendations for improvements in patient care based on analysis of resource utilization & patterns of care and education of staff. Work Schedule: 7:30 A.M. to 4:00 P.M. Full time-80 hours per two week pay period. Financial Discloser 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.