Utilization Management RN: Data-Driven Care Leader

U.S. Department of Veterans Affairs; Tucson (AZ); On-site; USD 85,000 - 120,000; Full time

Benefits offered by this job

Paid Time Off

Federal pension

Job summary

The U.S. Department of Veterans Affairs seeks a Utilization Management RN to apply evidence-based practices, use UM Criteria for complex reviews, and support data collection and analysis across admission and continued stay cases.

The role includes education for providers and collaboration on care plans within the acute care setting. Qualified candidates must hold an RN license, nursing degree, and meet VA education standards.

Qualifications

• English language proficiency
• Graduate of a nursing program accredited by ACEN or CCNE
• Current, full, active RN license in a US state or territory
• Bridge program pathway for advanced licensure and temporary appointment may apply
• Foreign nursing education requires degree equivalency validation

Responsibilities

• Apply UM Criteria to perform complex reviews.
• Collect, analyze, and report data for utilization management.
• Educate providers on admission and continued stay criteria and documentation.
• Collaborate on order of care and treatment plans within acute care.
• Lead education and quality improvement activities within the UM microsystem.

Skills

UM Criteria

Data analysis

Provider education

Leadership

Education

Associate Degree in Nursing or Diploma in Nursing

Bachelor of Science in Nursing (BSN)

Master's degree in nursing (MSN) or related field with BSN

Job description

The U.S. Department of Veterans Affairs seeks a Utilization Management RN to apply evidence-based practices, use UM Criteria for complex reviews, and support data collection and analysis across admission and continued stay cases.

The role includes education for providers and collaboration on care plans within the acute care setting. Qualified candidates must hold an RN license, nursing degree, and meet VA education standards.