Remote Utilization Review Rn Jobs in Des Moines, IA

Summary
The incumbent serves as an Advanced Medical Support Assistant assigned to a Patient Aligned Care Team (PACT) model or a Specialty Care Setting involved in a PACT model. The PACT team let is a primary care team that generally consists of a primary care provider (MD, NP, PA), registered nurse care manager, clinical associate (LPN or medical assistant/health technician) and an administrative associate (MA/MSA/health technician).
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Duties
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VA Careers - Medical Support Assistant: https://youtube.com/embed/EE9c4XkaELo
Total Rewards of a Allied Health Professional
Major duties include (but not limited to):

• Coordinates with the patient care team to review the clinic utilization by using various reports (e.g., Clinic Utilization Statistical Summary), ensure that the clinic setup is closely monitored to effectively support the needs of the clinic, and make any necessary adjustments.
• Develop/maintain effective and efficient communication with the patient, interdisciplinary team, VA medical centers, and other agencies (e.g., assist with communications during the inpatient to outpatient discharge; communicate with non-VA medical facilities; facilitate/process secure messaging with the patient and team; notify patients of normal lab results; develop and manage a tracking system for follow up care such as consults, tests, etc.).
• Participating in team huddles and team meetings to manage and plan patient care; setting priorities and deadlines, adjusting the flow and sequencing of the work to meet team and patient need.
• May work with the team to reinforce the plan of care and self-help solutions and entering appropriate information into the electronic record; monitoring pre-appointment requirements to assure readiness for patient visit/procedure (e.g., X-ray, lab work).
• Managing electronic wait list to verify and validate accuracy and resolve issues; participating and providing input in problem solving on operational issues or procedures in team meetings, performing administrative follow up actions;
• Participating in and independently following up on team huddles by sharing information and collaborating with the medical team to assure continuity of care.
• Evaluating patient information and clinic schedule lists to determine whether patient is vested.
• Educating providers about shared patients (those who receive their care at multiple VAs or those who have care in the community) and bringing to the attention of the provider.

Work Schedule: Monday - Friday, 7:30am - 4:00pm
Recruitment/Relocation Incentives (Sign-on Bonus): Not Authorized
Permanent Change of Station (Relocation Assistance): Not Authorized
Pay: Competitive salary and regular salary increases. When setting pay, a higher step rate of the appropriate grade may be determined after consideration of higher or unique qualifications or special needs of the VA (Above Minimum Rate of the Grade).
Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Selected applicants may qualify for credit toward annual leave accrual, based on prior [work experience] or military service experience.
Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child.
Child Care Subsidy: After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66
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)
Telework: Not Available
Virtual: This is not a virtual position.
Functional Statement #: 000000
Permanent Change of Station (PCS): Not Available
Requirements
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Conditions of employment

• You must be a U.S. Citizen to apply for this job.
• Selective Service Registration is required for males born after 12/31/1959.
• Must be proficient in written and spoken English.
• 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.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• Complete all application requirements detailed in the "Required Documents" section of this announcement.

As a condition of employment for accepting this position, you will be required to serve a 1 or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:

• your performance and conduct;
• the needs and interests of the agency;
• whether your continued employment would advance organizational goals of the agency or the Government; and
• whether your continued employment would advance the efficiency of the Federal service.

Upon completion of your trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
Qualifications
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 11:59 PM (ET) on 09/03/2026.
Medical Support Assistant Basic Requirements:
Citizenship: Citizen of the United States. (Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance to 38 U.S.C. § 7407(a).
Experience and Education:

• Experience: None.

OR

• Education: High school diploma, General Education Development equivalency certificate, or proficiency certificate from a State or territorial-level Board or Department of Education.

Licensure/Certification/Registration: None.
Foreign Education: To be creditable, education completed outside the U.S. must be deemed at least equivalent to that gained in a conventional U.S. program by a private organization specializing in the interpretation of foreign educational credentials.
Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service for requirements.
English Language Proficiency: Candidates must be proficient in spoken and written English in accordance with 38 U.S.C. § 7403(f).
Foreign Education. To be creditable, education completed outside the U.S. must have been submitted to a private organization that specializes in the interpretation of foreign educational credentials and such education must have been deemed at least equivalent to that gained in conventional U.S. programs.
Grade Determinations:

1. Creditable Experience: To be creditable, the experience must have demonstrated the knowledge, skills and abilities (KSAs) associated with current MSA responsibilities or an equivalent administrative patient support role in a non-VA medical inpatient or outpatient setting. Experience satisfying this requirement may be paid/non-paid employment as an MSA or an equivalent position in a non-VA hospital or clinic setting.
2. Part-Time Experience: Part-time experience as an MSA or equivalent administrative patient support in a non-VA medical inpatient or outpatient setting is creditable according to its relationship for the full-time workweek. For example, an MSA employed 20 hours a week, or on a 1/2-time basis, would receive one full-time workweek of credit for each two weeks of service.
3. Quality of Experience: Qualifying experience must be at a level comparable to MSA experience or equivalent administrative clinical support role in a non-VA medical inpatient or outpatient setting at the next lower grade level. For all assignments above the full performance level, the higher-level duties must consist of significant scope, administrative independence, complexity (difficulty), and range of varieties as described in this standard, at the specified grade level and be performed by the incumbent at least 25% of the time.

In addition to meeting the Basic Requirements, candidates must possess the required specialized experience and be able to demonstrate all Knowledge, Skills and Abilities (KSAs) as summarized below.
GS-5 Grade Experience: One year of experience equivalent to the GS-5 grade level that equips the candidate with the following:
Demonstrated Knowledge, Skills, and Abilities (KSAs): Candidates must demonstrate all of the KSAs below:

1. Advanced knowledge of medical terminology specific to understand medical diagnosis and procedures sufficient to communicate clinical staff instructions to patients.
2. Skill in customer service with the ability to identify customer concerns, and refer to the appropriate staff, as necessary, to ensure a satisfactory resolution.
3. Ability to operate computerized programs and systems in order to enter, modify, and retrieve sensitive medical and patient identifying information (PII) into or from electronic health records, scheduling systems, and/or reports.
4. Ability to schedule medical appointments in a clinical setting.
5. Ability to work independently in the accomplishment of a wide variety of duties performing patient support work.
6. Ability to communicate effectively and professionally in person, electronically, and/or by telephone, with internal and external customers.

AND
GS-6 Grade Requirements: Candidates must be able to also demonstrate all of the knowledge, skills and abilities below (KSAs):

1. Advanced knowledge of the technical health care process (including, but not limited to, scheduling across interdisciplinary coordinated care delivery and/or care in the community models and patient health care portals) as it relates to access to care.
2. Advanced knowledge of policies and procedures associated with interdisciplinary coordinated care delivery and/or care in the community operational activities that affect patient flow, and patient support care administrative functions to include, but not limited to appointment cycles, outside patient referrals, follow-up care, overbooking, provider availability, etc.
3. Advanced knowledge of medical terminology due to the technical nature of language utilized by clinicians.
4. Ability to collaborate and communicate with a wide range of medical clinicians across multiple disciplines (e.g., medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting to ensure medical care to patients is met.
5. Ability to independently set priorities and organize work to meet deadlines, ensuring compliance with established processes, policies, and regulations.
6. Ability to communicate tactfully and effectively, electronically, by phone, in person, and in writing, with internal and external customers. This may include preparing reports in various formats and presenting data to various organizational levels, as well as resolving patient concerns.

References: VA Qualification Standards - Office of the Chief Human Capital Officer (OCHCO).
The full performance level of this vacancy is GS-6
You will be asked to participate in a pre-employment examination or evaluation as part of the pre-employment process for this position. Questions about physical demands or environmental factors may be addressed at the time of evaluation or examination.
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: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.
Additional information
Receiving Service Credit for Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed.
During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions.
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