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Job Details

Revenue Utilization Review Nurse

Company name
U.S. Department of Veterans Affairs - Agency Wide

Salary
$59,964.00 to $120,904.00

Location
Las Vegas, NV

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Open & closing dates

02/09/2018

to

02/23/2018

Salary

$59,964 to $120,904 per year

Pay scale & grade

VN 00

Work schedule

Full-Time

Appointment type

Permanent

Location

3 vacancies in the following location:

Las Vegas, NV

Relocation expenses reimbursed

No

This job is open to

The public

U.S. citizens, nationals or those who owe allegiance to the U.S., and excepted service employees.

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Announcement number

CBAB-18-CSK-10109484

Control number

491063200

Duties

Duties

Summary

Who May Apply?

1st AOC: Employees of Station 736 or any of it's satellite locations

2nd AOC: Employees of the Department of Veteran Affairs

3rd AOC: Applicants with Status Eligibility

4th AOC: Public Applicants

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. How would you like to become a part of a team providing compassionate care to Veterans?

We are pleased to announce a dynamic and exciting opportunity available for an experienced, registered Revenue Utilization Review (RUR) nurse for the Veterans Health Administration, Office of Community Care, Consolidated Patient Accounts Center (CPAC) located in Las Vegas, NV.

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.

Learn more about this agency

Responsibilities

The RUR nurse is an active member of the revenue cycle program and functions within the scope of the CPAC for revenue reimbursement. The RUR Nurse is an expert nurse and possesses advanced clinical knowledge and communication skills to promote improvements in patient care by maximizing the potential for the recovery of funds through systematic evaluation and analytical review of clinical information. The RUR nurse is organizationally aligned under the CPAC structure and may be stationed on-site at a VA facility served by the CPAC or at the consolidated CPAC site.

Responsibilities of the RUR nurse includes the following:

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

* Uses advanced clinical knowledge and communication skills to efficiently and effectively perform the clinical reviews and contact the TPP for authorization of services provided to veterans

* Acts as a patient advocate and program liaison that 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 conducting special eligibility validation reviews including Service Connection (SC) , Agent Orange, Combat Vet, etc.

* Collaborates with clinical staff to provide education, feedback, and assistance regarding documentation of medical necessity, insurance review criteria, and SC issues and documents 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

* Participates in program development at the facility level and works to identify clinics that need to be added to the Huron High Dollar Clinic List

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

* Performs reviews for their facility as well as provides support to other facilities within the CPAC

* Conducts clinical appeals either oral or written ad required by TPPs to overturn denials and increase reimbursement

* Responds to customer service issues regarding SC and other Special Authority (SA) eligibility care/treatment to validate billing appropriateness or need for billing exemption and/or Veteran refund

Telework: A highly qualified applicant may be granted a telework schedule of up to three (3 days) a week, after one (1) year of employment with the West CPAC.

Flex/Compressed: Not available

Functional Statement: Registered Nurse Revenue - Utilization Review (RUR) #000000

Bargaining Unit: 1276

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

Work Schedule: 8:00 AM to 4:30 PM, Monday to Friday

Financial Disclosure Report: Not Required

Travel Required

Not required

Supervisory status

No

Promotion Potential

00

Who May Apply

This job is open to…

Public

Questions? This job is open to 1 group.

Job family (Series)

0610 Nurse

Requirements

Requirements

Conditions of Employment

You must be a U.S. Citizen to apply for this job

Designated and/or random drug testing required

Selective Service Registration is required for males born after 12/31/1959

You may be required to serve a probationary period

Subject to a background/security investigation

Must be proficient in written and spoken English

Physical Requirements:

This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued sitting and computer use and typing. The RUR nurse must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on organizational needs and solve problems independently while utilizing critical thinking skills.

Selected applicants will be required to complete an online onboarding process.

Qualifications

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.

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.

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.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/

. 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. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html

Additional information

Annual leave shall accrue for full-time Nurses, and Nurse Anesthetists at the rate of 8 hours for each full biweekly pay period.

This job opportunity announcement may be used to fill additional vacancies.

It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.

This position is in the Excepted Service and does not confer competitive status.

United States Citizenship Required; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

VA encourages persons with disabilities to apply. The health related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority.

Veterans and Transitioning Service Members: Please visit the VA for Vets

site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.

If you are unable to apply online view the following link for information regarding an Alternate Application

How You Will Be Evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, résumé, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

NOTE: Candidate's education and length of nursing practice (experience) will be considered by a Nurse Professional Standards Board in determining the grade and salary of the applicant selected. The recommended salary may be at any point in the range listed for this vacancy.

Experience as an RN will be evaluated to determine if the experience is of an acceptable level of quality with regard to the following four dimensions of nursing: Practice, Professional Development, Collaboration and Scientific Inquiry. Each dimension of practice has criteria that demonstrate essential core competencies for VHA Nursing Personnel. The criteria are as follows:

Practice: practice, ethics and resource utilization;

Professional Development: performance, education/career development;

Collaboration; collaboration, collegiality;

Scientific Inquiry: quality of care, research

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

Background checks and security clearance

Security clearance

Public Trust - Background Investigation

Required Documents

Required Documents

To apply for this position, you must provide a complete Application Package which includes:

VA Form 10-2850a, AND and a copy of your nursing license

Resume

Transcript

VA Form 10-2850a - Application for Nurses and Nurse Anesthetists can be found at: http://www.va.gov/vaforms/search_action.asp?FormNo=2850&tkey=&Action=Search

, and is REQUIRED at time of submission along with the documents highlights in the required document bullets above.

The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist

to ensure you have included all documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's, etc.

DD-214

VA Form 10-2850a, AND and a copy of your nursing license

VA Disability Letter

Resume

SF-50

Transcript

If you are relying on your education to meet qualification requirements:

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. Therefore, provide only the attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education

Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.

Benefits

Benefits

A career with the U.S. Government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Learn more about federal benefits

Review our benefits

Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time, or intermittent. Contact the hiring agency for more information on the specific benefits offered.

How to Apply

How to Apply

All applicants are encouraged to apply online. To apply for this position, you must complete the full questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 02/23/2018 to receive consideration.

To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire.

Click Submit My Answers to submit your application package.

NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.

To verify your application is complete, log into your USA JOBS account, https://my.usajobs.gov/Account/Login

, select the Application Status link and then select the more information link for this position. The Details page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USA JOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USA JOBS account or your application will be incomplete.

Agency contact information

Christian Kelley

Phone

7853503967

Email

CHRISTIAN.KELLEY@VA.GOV

Address

VA WCPAC Las Vegas 736

1085 Palm Airport DR

Las Vegas, NV

US

Learn more about this agency

Next steps

Once your online application is submitted you will receive a confirmation notification by email. After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.

You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center

Fair & Transparent

Fair & Transparent

The Federal hiring process is setup to be fair and transparent. Please read the following guidance.

Equal Employment Opportunity Policy

The United States Government does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.

Equal Employment Opportunity (EEO) for federal employees & job applicants

Reasonable Accommodation Policy

Federal agencies must provide reasonable accommodation to applicants with disabilities where appropriate. Applicants requiring reasonable accommodation for any part of the application and hiring process should contact the hiring agency directly. Determinations on requests for reasonable accommodation will be made on a case-by-case basis.

A reasonable accommodation is any change to a job, the work environment, or the way things are usually done that enables an individual with a disability to apply for a job, perform job duties or receive equal access to job benefits.

Under the Rehabilitation Act of 1973, federal agencies must provide reasonable accommodations when: An applicant with a disability needs an accommodation to have an equal opportunity to apply for a job.

An employee with a disability needs an accommodation to perform the essential job duties or to gain access to the workplace.

An employee with a disability needs an accommodation to receive equal access to benefits, such as details, training, and office-sponsored events.

You can request a reasonable accommodation at any time during the application or hiring process or while on the job. Requests are considered on a case-by-case basis.

Learn more about disability employment and reasonable accommodations

or how to contact an agency.

Legal and regulatory guidance

Financial suitability

Social security number request

Privacy Act

Signature and false statements

Selective Service

New employee probationary period

Note: We cannot accept applications on behalf of Federal Agencies. Application instructions are listed within the Job Description.

federalgovernmentjobs.us

Company info

U.S. Department of Veterans Affairs - Agency Wide
Website : http://www.va.gov/

Company Profile
The Veterans Health Administration is home to the United States’ largest integrated health care system consisting of 152 medical centers, nearly 1,400 community-based outpatient clinics, community living centers, Vet Centers and Domiciliaries. Together these health care facilities and the more than 53,000 independent licensed health care practitioners who work within them provide comprehensive care to more than 8.3 million* Veterans each year.

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