Revenue Utilization Review (RUR) Assistant Nurse Manager
The RUR ANM is responsible to provide leadership and supervision to the RUR staff nurses and Program Support Assistants (PSAs) who review (PSAs use algorithm) service connection (SC) and special authority (SA) eligibility before relaying any information to external reviewers representing third-party payers (TPPs). The RUR ANM possesses clinical and nurse leadership skills and demonstrates this through communication, mentoring and grade-appropriate critical thinking. Responsibilities of the RN ANM include the following:
The RUR ANM guides designated subordinates to collaborate among interprofessional team members involved in each patient's care to draw team members' input and form the most comprehensive clinical picture, which the staff nurse then relays to insurance reviewers. The RUR ANM's primary commitment is to the patient, whether an individual, family, group, or community (ANA Code of Ethics for Nurses). Leads and organizes the RUR nursing program to ensure continuity of operations , peer accountability and consistency in nursing practice and RUR program contributions to improvements in access to and quality of care. Functions as a competent consultant in clinical practice and revenue utilization review. Systematically evaluating current practice, and formulating outcomes for groups of nurses, patients and/or organizational processes within revenue utilization review nursing, Participates in establishing goals, solving problems and collaborating with other departments both in the facility and in the CPAC to enhance the clinical RUR nursing program. Reads and correctly interprets CPAC RUR policies and procedures and guidelines and ensures staff compliance. Work Schedule:
8:
00am- 4:
30pm M-F, per organizational needs Telework:
Possible for highly qualified applicants after successful completion of training. Telework may be available up to 2 days per week. Virtual:
This is NOT a Virtual or Remote position. One vacancy is located in Smyrna, TN. One vacancy is negotiable. Selectee will work from their duty station. Flex/Compressed:
Not available Functional Statement:
RUR Assistant Nurse Manager FS #69284A, #49321A, and #93640A Full Performance Level:
Grade III. The actual grade at which an applicant may be selected for this vacancy is in the range of I to III To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10/03/2019. 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. 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:
At least five (5) years clinical nursing experience as a RN, managed care experience as a RN or case management experience as a RN highly desirable; proficiency in computer software programs (such as MS Word, Excel, Outlook, Explorer); strong writing; strong analytical ability, health assessment ability to obtain descriptions about patient symptoms, how the symptoms developed, and a process to discover any associated physical findings to identify level of care needed. 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 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's 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 year's of nursing practice/experience; OR a Doctoral degree and approximately 2-3 year's of nursing practice/experience. 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:
This position requires visual acuity, hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued sitting and computer use and typing. The RUR Assistant Nurse Manager must be an individual capable of working effectively in stressful situations and able to shift priorities based on organizational needs.
Estimated Salary: $20 to $28 per hour based on qualifications.
The RUR ANM guides designated subordinates to collaborate among interprofessional team members involved in each patient's care to draw team members' input and form the most comprehensive clinical picture, which the staff nurse then relays to insurance reviewers. The RUR ANM's primary commitment is to the patient, whether an individual, family, group, or community (ANA Code of Ethics for Nurses). Leads and organizes the RUR nursing program to ensure continuity of operations , peer accountability and consistency in nursing practice and RUR program contributions to improvements in access to and quality of care. Functions as a competent consultant in clinical practice and revenue utilization review. Systematically evaluating current practice, and formulating outcomes for groups of nurses, patients and/or organizational processes within revenue utilization review nursing, Participates in establishing goals, solving problems and collaborating with other departments both in the facility and in the CPAC to enhance the clinical RUR nursing program. Reads and correctly interprets CPAC RUR policies and procedures and guidelines and ensures staff compliance. Work Schedule:
8:
00am- 4:
30pm M-F, per organizational needs Telework:
Possible for highly qualified applicants after successful completion of training. Telework may be available up to 2 days per week. Virtual:
This is NOT a Virtual or Remote position. One vacancy is located in Smyrna, TN. One vacancy is negotiable. Selectee will work from their duty station. Flex/Compressed:
Not available Functional Statement:
RUR Assistant Nurse Manager FS #69284A, #49321A, and #93640A Full Performance Level:
Grade III. The actual grade at which an applicant may be selected for this vacancy is in the range of I to III To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 10/03/2019. 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. 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:
At least five (5) years clinical nursing experience as a RN, managed care experience as a RN or case management experience as a RN highly desirable; proficiency in computer software programs (such as MS Word, Excel, Outlook, Explorer); strong writing; strong analytical ability, health assessment ability to obtain descriptions about patient symptoms, how the symptoms developed, and a process to discover any associated physical findings to identify level of care needed. 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 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's 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 year's of nursing practice/experience; OR a Doctoral degree and approximately 2-3 year's of nursing practice/experience. 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:
This position requires visual acuity, hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued sitting and computer use and typing. The RUR Assistant Nurse Manager must be an individual capable of working effectively in stressful situations and able to shift priorities based on organizational needs.
- Department:
0610 Nurse - Salary Range:
$48,693 to $95,120 per year
Estimated Salary: $20 to $28 per hour based on qualifications.
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