Utilization Management Assistant Jobs in Kentucky

Summary
The Clinical Medical Director directly reports the Chief of Primary Care / ACOS and will be responsible for all aspects of medical care delivered to patients assigned to a Patient Aligned Care Team at the Main Medical Center Campus or requested CBOC.
The 2-page Resume requirement does not apply to this occupational series. For more information, refer to Required Documents below.
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Duties
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The Clinical Medical Director must be able to perform all services required in the practice of Internal Medicine in the context of the VA system (the spectrum of patient illnesses typically seen in the Medical Center) and document appropriately in the electronic record. Educational experiences are also provided to appropriate health care personnel who are involved in Primary Care (e.g., admitting, or consultative service team members such as fellows, residents, medical students, social work interns/staff, physician assistant and nursing students, Utilization management personnel, and Internal Medicine staff).
Duties include, but are not limited to:

• Participate in all required UM/QM activities relating to Primary Care to monitor the preadmission screening process and its success in impacting InterQual appropriate outpatient admissions / observation status utilization performance measures.
• Responsible for outpatient care, and graduate and undergraduate medical education, and scientific research as appropriate.
• During scheduled tour hours, be available for all internal medicine interventions as part of the PACT / CBOC staff team.
• Perform outpatient medical evaluations and treatment.
• Provide or assist PA/NPs in the process of evaluation and treatment of the Internal Medicine patient, and actively participate in corrective actions against untoward responses to medical interventions.
• Apply accepted protocols for assessment of individual patients presenting with various medical conditions according to accepted community and VA standards.
• Arrange for appropriate follow-up care for those patients following scheduled appointments.
• Assist in representing the Primary Care at all applicable hospital administrative and patient care meetings.
• Assist in meeting with all providers in the Primary Care regularly to review protocols, procedures, expectations for transported/transferred patients, including minor trauma victims.
• Assist in monitoring established VA/VISN/Joint Commission, etc., performance measures and identified goals for the Primary Care team (e.g., physician report card), and provide providers with group and individual feedback on how to improve and/or sustain achieved success in such metrics/measures, including faculty development programs where applicable.
• Regularly meet with Internal Medicine providers and nursing staff to discuss departmental performance and barriers to achieving performance measure/workflow success. Develop solutions at the lowest level whenever possible, employing LEAN management principles and thinking.
• Work to eliminate wasted efforts/work/testing in the Primary Care section, developing and/or utilizing preexisting patient care protocols (Acute Coronary Syndrome, Stroke, Sepsis) and monitoring the success of those efforts.

Work Schedule: Monday-Friday; 8:00 am- 4:30 pm.
VA offers a comprehensive total rewards package. VHA Physician Total Rewards.
Recruitment Incentive (Sign-on Bonus): Is being offered to qualified candidates.
Pay: Competitive salary, annual performance bonus, regular salary increases
Paid Time Off: 50-55 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year and possible 5 day paid absence for CME)
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
CME: Possible $1,000 per year reimbursement (must be full-time with board certification)
Malpractice: Free liability protection with tail coverage provided
Contract: No Physician Employment Contract and no significant restriction on moonlighting
The VA has been named as one of the Top 5 Best Places to Work in the federal government.
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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.
• 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 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
To qualify for this position, you must meet the basic requirements as well as any additional requirements (if applicable) listed in the job announcement. Applicants pending the completion of training or license requirements may be referred and tentatively selected but may not be hired until all requirements are met. Currently employed physician(s) in VA who met the requirements for appointment under the previous qualification standard at the time of their initial appointment are deemed to have met the basic requirements of the occupation.
Basic Requirements:

• United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• Degree of doctor of medicine or an equivalent degree resulting from a course of education in medicine or osteopathic medicine. The degree must have been obtained from one of the schools approved by the Department of Veterans Affairs for the year in which the course of study was completed.
• Current, full and unrestricted license to practice medicine or surgery in a State, Territory, or Commonwealth of the United States, or in the District of Columbia.
• Residency Training: Physicians must have completed residency training, approved by the Secretary of Veterans Affairs in an accredited core specialty training program leading to eligibility for board certification. (NOTE: VA physicians involved in academic training programs may be required to be board certified for faculty status.) Approved residencies are: (1) Those approved by the Accreditation Council for Graduate Medical Education (ACGME), b) OR
  [(2) Those approved by the American Osteopathic Association (AOA),OR
  (3) Other residencies (non-US residency training programs followed by a minimum of five years of verified practice in the United States), which the local Medical Staff Executive Committee deems to have provided the applicant with appropriate professional training and believes has exposed the physician to an appropriate range of patient care experiences.
  Residents currently enrolled in ACGME/AOA accredited residency training programs and who would otherwise meet the basic requirements for appointment are eligible to be appointed as "Physician Resident Providers" (PRPs). PRPs must be fully licensed physicians (i.e., not a training license) and may only be appointed on an intermittent or fee-basis. PRPs are not considered independent practitioners and will not be privileged; rather, they are to have a "scope of practice" that allows them to perform certain restricted duties under supervision. Additionally, surgery residents in gap years may also be appointed as PRPs.
• Proficiency in spoken and written English.

Preferred Experience:

• Supervisory experience.
• Board Certified/Eligible in Family or Internal Medicine by the American Board Family Medicine or the American Board of Internal Medicine.
• Current BLS required /ACLS desirable.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
Physical Requirements: Per VA Directive and Handbook 5019 - a physical examination will be conducted based on the physical requirements of the position. A physical examination prior to placement is required. Long periods of standing or walking in the operating room setting and outpatient clinic will be encountered. The mental/sensory requirements include recall, reasoning, problem-solving, hearing, speaking clearly, writing legibly, reading, and logical thinking. The environment's pace can vary from steady to a sometimes-fast pace requiring handling of multiple priorities, frequent, sometimes intense customer, intense customer interactions, and the ability to adapt to frequent changes in a sometimes-noisy environment.
Education
Degree of Doctor of Medicine or an equivalent degree resulting from a course of education in allopathic medicine or osteopathic medicine. The degree must have been obtained from an institution whose accreditation was in place for the year in which the course of study was completed. Approved schools are:

1. Schools of medicine accredited by the Liaison Committee on Medical Education (LCME) for the year in which the degree was granted, or
2. Schools of osteopathic medicine approved by the Commission on Osteopathic College Accreditation of the American Osteopathic Association for the year in which the degree was granted.
3. For foreign medical graduates not covered in (1) or (2) above, facility officials must verify with the Educational Commission for Foreign Medical Graduates (ECFMG) that the applicant has met requirements for certification, and must obtain a copy of the ECFMG certificate, if claimed by the applicant. [If the applicant does not claim an ECFMG certificate, facility officials must still confirm that the medical school meets (or met) ECFMG eligibility requirements for the year the candidate graduated.]

NOTE: The Under Secretary of Health or designee in the VHA Central Office may approve the appointment under authority of 38 U.S.C. 7405 of a physician graduate of a school of medicine not covered above if the candidate is to be assigned to a research, academic, or administrative position with no patient care responsibilities. The appointment will be made only in exceptional circumstances where the candidate's credentials clearly demonstrate high professional attainment or expertise in the specialty area.
Additional information
This job opportunity announcement may be used to fill additional vacancies.
It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.
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. Contact the hiring agency for more information on the specific benefits offered.