The Indian Health Service (IHS) is the principal federal health care provider and health advocate for American Indians and Alaska Natives (AI/AN). The IHS goal is to raise Indian health status to the highest possible level. IHS provides leadership and direction to programs and activities designed to improve health outcomes to over 1.9 million AI/AN through a system of IHS, Tribal and Urban operated facilities and programs.
For information on the IHS visit IHS.GOV
The IHS is required by law to give absolute preference to qualified applicants who meet the Secretary of the Interior's definition of Indian for appointment to vacancies within the IHS in accordance with established IHS policy as outlined in the Indian Health Manual Part 7, Chapter 3. The IHS is an Equal Opportunity Employer.
This position is being Re-Advertised to solicit additional applications. Applicants who applied previously need not reapply unless submitting updated and/or missing information.
This position is being announced concurrently under Excepted Service and Merit Promotion procedures. Please review vacancy announcement number IHS-R1-NN-987900-ESEP/MP number for eligibility requirements. NOTE: Applicants must apply separately for each announcement in order to be considered
The Nurse Specialist (Utilization Review Nurse Coordinator) is located in the Professional Quality Services Division at Northern Navajo Medical Center, Shiprock, New Mexico. Responsible for planning, directing, implementing and evaluating the functions and requirements of the utilization review. This position reports to Quality Assessment Officer.
- Utilization Review an on-going process for assessing and monitoring patient charts and health status to determine appropriateness and completeness of medical documentation, length of stay, intensity of services, and allocation and utilization of resources for patient care.
- Utilizing Nurse professional knowledge and training, will review medical documentation and correct such deficiencies to meet established criteria for severity of illness and intensity of service.
- Conducts analysis of policies and directive pertinent to the administration and management of the utilization review and third party collection programs in order to define requirements and objectives.
- Responsible for identifying patients whose third party payors require admission preauthorization, procedures and transfers, communication with the payors and releasing medical information necessary to obtain approval.
- Serves as Chair of the Utilization Review committee, manages the committee including rooms, notifications, and assures committee documentation is complete and accurate. Maintains files and compiles with Records Management requirements.