This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Learn more This position is located in the Utilization Management (UM), Department of Nursing, at the John D. Dingell VA Medical Center in Detroit Michigan. The Utilization Management Nurse (UMRN) will identify and evaluate bed availability in BMS (Bed Management System) on all patient care departments to facilitate effective utilization of inpatient beds. He/She maintains authority for patient placement during the administrative tour of duty and follows priority and unit admission criteria in assigning patients to appropriate units. Incumbent attends daily bed briefing meetings prior to the beginning of the shift and at the end of the shift. The incumbent maintains prompt, ongoing, effective communication with physicians, CNMs, charge nurses, and Environmental Management Service regarding admissions, transfers, and discharges. The incumbent will participate in collecting, monitoring, and analyzing data related to bed availability and the bed control process. The incumbent will be responsible for all relative performance measure reports. As part of the UM duties, the nurse will function independently and is supervised by the Chief of Patient Care Services. The nurse is responsible for applying clinical skills in reviewing, assessing, and evaluating patient care processes for appropriateness of care across the continuum of care. The nurse must effectively communicate with physicians, nurses, and other health care providers in obtaining or verifying data for review and formulating a plan of care. The Nurse will have thorough knowledge of patient medical records and is able to retrieve pertinent information from multiple sources/packages for case review (e.g., CPRS, VistA, etc.). As a UM nurse, will possess functional knowledge of VERA reimbursement model, Decision Support System (DSS), and Centers for Medicare/Medicaid Services (CMS), and will work collaboratively with the UR Fee Nurse. The UM responsibilities for all activities of the UM program within her/his assigned areas include: Utilizing and applying clinical knowledge, skills and resources to assess appropriate level of care based on clinical presentation and required resources Using standardized Inter-Qual criteria to conduct clinical reviews for appropriateness of admissions and continuing stay as directed by VISN 11 Utilization Management Plan and any local modifications. Serving as a liaison with the clinical staff to facilitate quality of care that is cost-effective, identify organizational barriers and recommend improvements. Assisting in the management of patient classification in prospective payment systems such as DRG, or VERA models. Systematically documenting, analyzing, and reporting administrative and clinical data translating into information for performance improvement. Educating staff (administrative and clinical) on the processes leading to both appropriate utilization of resources and quality of care; and NUMI. Serving as a facilitator for individual patient's episodes of care to ensure appropriate level of care opportunities is accessed. Work Schedule: UM: 7:00 am - 3:30 pm, Monday-Friday UM/ED: 11:00 am-7:30pm, Monday - Friday UM/Bed Control: 11:30 am -10:00 pm, (4) 10 hour shifts per week with every other weekend rotating Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized EDRP Authorized: Contact Contact Brian.Huhman@va.gov OR Eve.Harper@va.gov, the EDRP Coordinator for questions/assistance Financial Disclosure Report: Not required This is an Open Continuous Announcement. Resumes/Questionnaires received in USA Staffing in response to this announcement will be maintained in the USA Staffing job file. Qualification determinations will be done based on the applicant's resume/questionnaire/documents submitted for the position and a list of qualified candidates will be referred to Service.**The first list of eligible applicants will be pulled for referral on Thursday, November 18, 2021**. Subsequent referrals of qualified applicants will be referred on the 15th of each month (Cutoff dates) or as need it. The vacancy announcement will remain open until closed, canceled or filled.**
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.