You will serve as a Nurse Consultant in the Healthcare Business Department, Directorate for Administration of NAVAL HOSPITAL LEMOORE.
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Assesses, plans, monitors, and evaluates patient care through utilization review activities such as prospective (pre-certification), concurrent, retrospective and focused reviews; and through clinical pathways and clinical practice guidelines for performance outcomes.
Reviews specialty consults for appropriateness of setting and medical necessity.
Reviews medical records for deviations from screening criteria.
Collects utilization data, monitors, performance, and identifies opportunities for improvement and initiates performance improvement plans.
Provides on-going education to patients, providers, and staff related to utilization management.
Develops protocols and procedures to manage the Utilization Management program for properly directing referral management.
HelpRequirements Conditions of Employment
Must be a US Citizen.
Must be determined suitable for federal employment.
Must participate in the direct deposit pay program.
New employees to the Department of the Navy will be required to successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/.
Generally, current federal employees applying for GS jobs must serve at least one year at the next lower grade level. This requirement is called time-in-grade. Time-in-grade requirements must be met by the closing date of this announcement.
Within the Department of Defense (DoD), the appointment of retired military members within 180 days immediately following retirement date to a civilian position is subject to the provisions of 5 United States Code 3326.
You will be required to obtain and maintain an interim and/or final security clearance prior to entrance on duty. Failure to obtain and maintain the required level of clearance may result in the withdrawal of a job offer or removal.
You will be required to obtain and maintain a current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.
You will be required to obtain and maintain a current Basic Life Support (BLS) license.
Successful completion of a pre-employment drug test (including marijuana) is required. A tentative offer of employment will be rescinded if you fail to report to the drug test appointment or pass the test. You will be subject to random testing.
Applicants must meet the following positive education qualifications requirements of the Office of Personnel Management (OPM) Qualifications Standards Manual: Applicants must possess
Education: A graduate or higher level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education (external link), Council on Accreditation of Nurse Anesthesia Educational Programs (external link), Accreditation Commission for Midwifery Education (external link), or an accrediting body recognized by the U.S. Department of Education (external link) at the time the degree was obtained.
Degree from Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools (external link) is required for individuals who graduated from foreign nursing schools.
Advanced Practice Nurse Positions: For Advanced Practice Nurse (APN) positions, applicants must possess a graduate or higher level degree in nursing from an accredited educational program in the area of expertise or specialty indicated by the position.
Areas of specialties for positions include, but are not limited to, Acute Care, Anesthesia, Community Health, Family, Geriatric, Home Health, Midwifery, Neonatal, Oncology, Pediatric, Psychiatric, Allergy and Immunology, Women's Health, Cardiovascular, Dermatology, Occupational Health, Orthopedic, Respiratory, or other specialties identified for the position.
Licensure: For all grade levels and positions, applicants must have passed the National Council Licensure Examination (external link). In addition, they must possess a current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.
Additional License Requirements for Advanced Practice Nurse Positions: Applicants for Advanced Practice Nurse positions must be licensed or registered by a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States in the clinical specialty required by the position.
Experience: The work experience must have equipped the applicant with the particular knowledge, skills, and abilities to successfully perform the duties of the position. At the GS-9 and above grade level, many positions may require experience in a specialty area of nursing.
In addition to the Basic Requirements for this position, Nurse Consultant, GS-0610-11, your resume must also demonstrate at least one year of specialized experience at or equivalent to the GS-09 grade level or pay band in the Federal service or equivalent experience in the private or public sector. Specialized experience must demonstrate the following:
Experience assessing, planning, monitoring, and evaluating patient care through utilization management.
Experience monitoring, identifying, and initiating performance improvement programs opportunities for improvement.
Experience utilizing the skills of advanced concepts, principles, and practices to perform highly specialized nurse consultant assignments to administer the Utilization Management Program.
Experience using clinical interpretations from guidelines to make decisions regarding appropriateness of setting and medical necessity of consults.
Additional qualification information can be found from the following Office of Personnel Management website:
Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., professional, philanthropic, religious, spiritual, community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment.
Successful completion of a PhD or equivalent doctoral degree from a professional nursing educational program or related medical science field;
At least one full year of professional nursing experience (equivalent to the GS-9 grade level) and possession of a diploma, associate degree, bachelor's degree, or master's degree from a professional nursing educational program.
Department Of The Navy