Insurance Risk Manager Jobs in Louisville, KY (NOW HIRING)

Summary
Robley Rex VA Healthcare System, Louisville, Kentucky is currently recruiting for a Registered Nurse-Risk Manager Louisville, Kentucky 603.
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Duties
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The main duties of the Risk Manager, Activations Team are as follows:

• The Activations Team Risk Manager (RM) is a registered professional nurse in the Consultant career path, qualified by education and experience to execute position responsibilities that demonstrate leadership, experience, and creative approaches to provide an effective Risk Management Program and to the delivery of quality patient care. This includes responsibility for the daily management and/or oversight of Risk Management activities including interpreting VA handbooks and directives related to risk management; day-to-day coordination and implementation of Occurrence Screen processes, case management of Peer Reviews and mortality data tracking; Institutional Disclosure process oversight; processes relating to Tort Claims, State Licensure, and National Practitioner Data Bank reporting, including tracking and trending; process management and oversight for Administrative Boards of Investigation, and formal fact findings
• The RM Nurse reviews all risk management issues that relate to the facility; maintains necessary records; and ensures that issues are handled in an appropriate, accurate, and timely manner. The RM Nurse serves as a liaison to District Counsel for technical-legal clinical and administrative issues, and consultant for policies and procedures involving risk management related issues. The RM Nurse provides direct staff support to service chiefs, and others in planning, designing, integrating, implementing, modifying, and evaluating the effectiveness of program components and/ or services to improve the quality of patient care and the appropriateness and timeliness of services provided. The RM Nurse collaborates with the Risk Manager and Patient Safety Managers to trend and analyze patient incidents thus ensuring the integration of the Patient Safety and Risk Management Programs
• Delivers safe care to assigned patients, while developing technical competencies
• Formulates a plan of care based on nursing assessments, using the nursing process, based on the ANA Standards of Nursing Practice
• Documents the nursing process
• Demonstrates grade-appropriate and consistent critical thinking skills
• Treats all patients and families with dignity and respect
• Maintains professional boundaries with patients, families, and employees
• Demonstrates compliance with infection control practices, such as hand washing and wearing of appropriate personal protective equipment
• Conserves resources effectively by using supplies and equipment in a responsible manner
• Applies recently acquired knowledge to the care of patients
• Participates in unit based educational activities
• Practices and fosters in staff that access to understandable health information can empower individuals to participate in their health
• Encourages and supports patients and families to participate in care and decision-making at the level they choose
• Communicates the plan of care with the patient and discusses the patient's progress with other health care providers
• Makes changes in own practice in response to performance improvement findings

Preferred experience: The ideal candidate will demonstrate advanced clinical experience and leadership in risk management within an acute care or complex healthcare setting. Experience should include implementing and evaluating risk management programs, collaborating with interdisciplinary teams, and ensuring compliance with national standards (e.g., The Joint Commission, VHA Directives). Preferred candidates will have proven ability to identify, analyze, and mitigate clinical and organizational risks, and will be familiar with the regulatory, ethical, and legal aspects of healthcare risk management.
VA offers a comprehensive total rewards package: VA Nurse Total Rewards
Pay: Competitive salary, regular salary increases, potential for performance awards
Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Licensure: 1 full and unrestricted license from any US State or territory
Work Schedule: Monday-Friday, 8:00am-4:30pm
Telework: Ad-hoc
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not authorized
Permanent Change of Station (PCS): Not authorized
Financial Disclosure Report: Not required
Pay Schedule: NF45
Requirements
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Conditions of employment

• U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
• Selective Service Registration is required for males born after 12/31/1959.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Must pass pre-employment physical examination.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• You may be required to serve a probationary period.
• Complete all application requirements detailed in the "Required Documents" section of this announcement.

Qualifications
Basic Requirements:

• English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
• Graduate of a school of professional nursing approved by the appropriate 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); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (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 to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD).
• 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. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.)

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification.
Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/13002606.
Grade/Level
Scope
Education
Nurse I, Level I
Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies.
An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required.
Nurse I, Level II
Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex.
An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required.
Nurse I, Level III
Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations.
An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience.
Nurse II
Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others.
A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience.
Nurse III
Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting.
MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III.
*Note: Foreign education programs/degrees are not creditable as related degrees.
Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
Physical Requirements: It is VA policy to ensure that all selected applicants and employed personnel are physically, mentally and emotionally fit to perform the duties of the position to which assigned. A pre-placement physical examination is required for all fulltime, part-time and intermittent employees identified by VA Directive and Handbook 5019. The pre-placement physical examination shall be completed prior to appointment to determine the physical and mental fitness for candidates for appointment in VA. The examination will be concerned with the mental and physical ability of the applicant to satisfactorily perform the duties of the proposed assignment and will include requisite laboratory and other screening as required by Federal regulatory agencies. This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. This position requires that you are able to lift at least 50 lbs. Transferring patients and objects may be required. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations or operative/invasive procedures. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on organizational needs. Must complete annual Employee Health requirements, such as annual Influenza vaccination, TB screening or testing, as a condition of employment.
Additional information
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