Remote Utilization Review Rn Jobs in Auburn, NY (NOW HIRING)

Summary
Quality Manager provides leadership, oversight, direction and development in performance improvement, utilization review, risk management, patient safety, data management, strategic and operational planning, and performance management processes throughout the Medical Center. The Quality Manager functions in a leadership role assisting and supporting the Director in accomplishing the goals of the Medical Center.
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Duties
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Duties include but are not limited to:

• Includes the functions of planning, directing, controlling, coordinating, and evaluating the Performance Improvement Program including Risk Management, Patient Safety Improvement, Accreditation Specialist, Utilization Review, V ASQIP, and facility systems redesign.
• Participates in executive decision making, policy determination and implementation strategies and advises the Director, Chief of Staff, other members of the executive team and staff in performance improvement and patient safety improvement concepts across the continuum.
• Provide administrative oversight and executive leadership and accountability for the Performance Improvement Management Service programs and processes at the Syracuse VAMC.
• Oversees creation and maintenance of a positive organizational climate and culture including such issues as work
  environment, diversity, employee recognition, and safety.
• Reviews quality data (IPEC, SAIL, Core Measures, etc.) for trends and early intervention.
• Applies clinical performance improvement methods, collects outcome data related to policy, procedure, and regulatory compliance and in collaboration with management, initiates performance improvement monitoring projects.
• Utilizes data and comparative analytical processes in recommending design and implementation of innovative programs to improve service excellence, customer satisfaction, and compliance with patient care and regulatory standards.
• Participates in appropriate executive-level decision making deliberations that affect compliance with regulatory standards, VHA Patient Safety Improvement Program, External Peer Review Program (EPRP), Peer Review Program, Risk Management Program, Continuous Readiness Program and survey accreditation.
• Overall responsibility and administrative oversight and direction for the facility wide programs listed below including ensuring integration of these programs into the facility's Performance Improvement Program to improve care, reduce risk to patients and staff and to foster a culture of safety in the organization:
  
  • Accreditation/Continuous Readiness Review Programs
  • Patient Safety (PS) Program
  • Protected Peer Review Program
  • Risk Management (RM) Program
  • External Peer Review Program (EPRP)
  • Utilization Management (UM)
  • Data Management
  • Process Improvement
• Overseeing the duties and responsibilities of the facility Lean/Six Sigma/Process Improvement Program under Quality Management Service
• Functions as an administrator, leader, educator, and consultant applying management theory in collaboration with other services
• Programmatic responsibility for the services and/or processes within specified area(s) of assignment and provides cross coverage for other positions within the service as appropriate
• Executes position responsibilities independently and collaboratively in accordance with the most current Scope and Standards of Nursing Practice within the specialty area
• Practices within the Rules and Regulations of the Nurse Practice Act of the state of licensure
• Executes leadership that is characterized by substantial and continuous responsibility and accountability for population groups or integrated programs that cross service and/or discipline lines and influence organizational mission and health care

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, 7:30am - 4:00pm
Telework: Ad hoc may be available at service discretion.
Virtual: This is not a virtual position.
Permanent Change of Station (PCS): Not Authorized.
PCS Appraised Value Offer (AVO): Not Authorized.
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 evaluation/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/13030146.
*Note: Foreign education programs/degrees are not creditable as related degrees.
The following Scope, Education and Dimension criteria must be met to qualify for Nurse IV:

• Scope: Executes leadership that is characterized by substantial and continuous responsibility and accountability for population groups or integrated programs that cross service and/or discipline lines and influence organizational mission and health care.
• Education: Master's degree in Nursing (MSN) and 4 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV; OR Master's degree in a *related field with a BSN and 4 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV; OR a Doctoral degree in nursing and 3 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV; OR a Doctoral degree in a *related field with a BSN and 3 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV. *Note: Foreign education programs/degrees are not creditable as related degrees.
• Dimensions:
  
  • Leadership. Leads health care delivery by leveraging evidence-based practices, industry-leading research, and innovative care models. Drives a shared vision and successfully leads change to improve performance and attain measurable outcomes at the program or service level.
  • Business Acumen. Transforms health care by implementing new processes, technology, informatics, and data analytics using business models and fundamental concepts of resource management at the program or service level.
  • Inspiring an Industry-Leading Lifestyle. Employs an industry leading, shared decision-making lifestyle. Cultivates a workforce that serves Veterans, families and caregivers of all backgrounds and builds trust, lifestyle competencies and catalyzes dynamic teams at the program or service level.
  • Communication and Relationship Management. Directs the effective use of relationship management principles to achieve positive customer service experiences that are consistent with professional organizational values, beliefs and practices at the program or services level.
  • Professional and Social Responsibility. Operationalizes a lifestyle of holistic care, health advocacy and health equity. Applies ethical principles in decision-making at the program or service level. Advances nursing knowledge through health science research and the translation and dissemination of evidence into practice to maximize the value to Veterans and the community.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service.
Additional information
This job opportunity announcement may be used to fill additional vacancies.
This position is in the Excepted Service and does not confer competitive status.
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.
If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.
Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.
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Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.
Benefits
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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. Opens in a new windowLearn more about federal benefits.
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Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent