Remote Utilization Review Rn Jobs in Fresno, CA (NOW HIRING)

Summary
The Surgical Nurse Practitioner, as a Title 38 advanced practice nurse is responsible for surgical care for any of the subspecialty surgical sections to include call coverage, General Surgery, Vascular, Thoracic, Urology, Orthopedics, Plastics Otolaryngology (Ear, Nose and Throat (ENT), Interventional Radiology, Podiatry, Ophthalmology, and Anesthesia. Care is provided in the following settings; outpatient, inpatient, operating Room (first assist), telehealth, video visits, and telephone care.
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Duties
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The Registered Nurse I/Level 2 is an ADVANCED BEGINNER nurse, "who can demonstrate marginally acceptable performance, have coped with enough real situations to note (or have pointed out to them by a mentor) the recurring meaningful situational components that are termed 'aspects' of the situation. Aspects require prior experience in actual situations for recognition" (Benner).
- In conjunction with the staff surgeon- prioritize, collaborate, and engages in facility performance measures in an effort to provide excellent care delivery processes in an efficient and safe manner.
- Collaborates with Attending Surgeons to review and act on routine consults.
- Acquires knowledge and applies the nursing process to systems or processes at the unit/team/work group level to improve patient care.
- Acquires knowledge and strives to apply leadership by collaborating with others in process improvement activities.
- Supports and enhances patient self-determination. Utilizes and applies available resource for patient and staff in addressing ethical issues.
- Identifies and assesses resource utilization and safety issues, appropriately reports issues to managements.
- Acquires knowledge and skills to continue to gain expertise in area of practice. Participates in educational activities to improve clinical knowledge, skills and enhance role performance.
- Evaluates practice of self using professional standards.
- Uses group process to identify, analyze and resolve care problems.
- Seeks out and participates in quality improvement activities that result in improved outcomes.
- Reviews and applies research to validate and or change self practice to improve patient outcomes
The Registered Nurse I/Level 3 is a COMPETENT nurse; "competence develops when the nurse begins to see his or her actions in terms of long-range goals or plans of which he or she is consciously aware. The plan dictates which attributes and aspect of the current and contemplated future situation are to be considered most important and those which can be ignored. A plan establishes a perspective, and the plan is based on considerable conscious, abstract, analytic contemplation of the problem. The competent nurse lacks the speed and flexibility of the proficient nurse but does have a feeling of mastery and the ability to cope with and manage the many contingencies of clinical nursing. The conscious, deliberate planning that is characteristic of this skill level helps achieve efficiency and organization" (Benner).
- In conjunction with the staff surgeon- prioritizes, collaborate and engages in facility performance measures in an effort to provide excellent care delivery processes in an efficient and safe manner.
- Assumes responsibility for review of routine consults and communicates with Attending Surgeon and requesting providers regarding additional care needs.
- Applies the nursing process to systems or processes at the unit/team/work group level to improve patient care.
- Develops leadership by involving others in process improvement activities.
- Supports and enhances patient self-determination. Provides resources for patient and staff in addressing ethical issues.
- Identifies and assesses resource utilization and safety issues, taking appropriate action.
- Acquires knowledge and skills to expand expertise in area of practice. Participates in educational activities to improve clinical knowledge, skills and enhance role performance.
- Evaluates practice of self and others using professional standards.
- Uses group process to identify, analyze and resolve care problems.
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: 7:30am - 4:00pm
Telework: Not Available
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): 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.
• English Language Proficiency. In accordance with 38 U.S.C. 7402(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
• 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 dentification 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
Advanced Practice Nurse (Nurse Practitioner) Basic Requirements

• Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a 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).
  • NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment.
• License - All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia.
• Basic Board Certification - All APN (NPs) must maintain full and current basic board certification as a Psychiatric-Mental Health Nurse Practitioner (PMHNP) from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared.
• Basic Board Certification - All APN (NPs) must maintain full and current basic board certification in one of the following: Acute Care Nurse Practitioner (ACNP) or Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared.
• NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) assignment that are also 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.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II:
Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B).

• Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required.
• Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements:
  
  • Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care.
  • Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care.
  • Professional Development. Acquires knowledge and skills to develop expertise in area of practice.
  • Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III:

• Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care.
• Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level.
• Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements:
  
  • Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations.
  • Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program.
  • Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility.
  • Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork

Physical Requirements: See VA Directive and Handbook 5019.
Education
Nursing Bridge Programs. Nursing bridge programs are accelerated nurse education programs which rely upon existing nursing knowledge and education. Graduates from nursing bridge programs that meet accreditation requirements specific grade level requirements in this standard must also be met in addition to the following:
(a) Master's Level Bridge Program Education Appointments Prior to Graduation. Individuals attending a master's level bridge program in nursing who achieve the level in their education in which they 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 a 3 temporary basis for any period up to three years contingent upon full completion of the professional nursin