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Full Time
6/19/2025
San Antonio, TX 78207
(24.1 miles)
DescriptionSummary: The RN Supervisor is accountable for supervising the delivery of high-quality, cost-effective care to patients. Responsible in assisting the Director for analyzing, planning, implementing, evaluating, and communicating processes and programs which enhance, strengthen and integrate the services comprising the nursing department. Responsible for participation in the development and implementation of the service line strategic business plans; and for creating an environment, which continuously supports improvement of operational, financial, and clinical components. Assumes primary responsibility for effective supervision of nursing activities of assigned area(s). Assists management of financial and human resources to ensure services meet established quality and productivity standards. Provides feedback and assistance concerning customer satisfaction, staff development, and associate performance and satisfaction. The Supervisor is responsible for the daily operations of a Nursing department on a 24-hour basis. The Supervisor collaborates with other clinical and ancillary departments to meet organizational and department-specific Quality and Safety Measures, Community Values, Business Literacy, and Service Excellence goals. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Implementing and monitoring programs and practices for the delivery of safe and efficient quality nursing care for patients and their families. Ensuring consistent application of nursing services policies and standards throughout the organization. Monitoring patient outcomes and quality and effectiveness of nursing care. Overseeing the performance of teams; identifying and addressing staff training and development needs. Job Requirements: Education/Skills Bachelor of Science Degree in Nursing required for Magnet facilities, otherwise preferred. Experience 2 years of clinical patient care experience in a relevant setting. Previous Lead or Supervisor experience overseeing work of assigned units, preferred. Previous healthcare management experience preferred. Licenses, Registrations, or Certifications BLS required. RN License in state of employment or compact. Credential Grace Periods: If additional credentials are required per the Position Requirements section, a grace period to obtain the certification will apply, dependent on your experience level. Any Candidate/Associate with at least one year of acute care clinical experience in a similar service line within the past three years is considered anExperienced Associate. Any Candidate/Associatewho doesnothave at least one year of full-time acute care clinical experience in the same service line within the past three years is considered anExperienced Associate New to the Specialty. CredentialGrace Periods forExperienced AssociatesGrace Periods forNew Graduates & Experienced Associates New to the SpecialtyBasic Life Support (BLS)No grace period. AHA or Red Cross accepted at time of hire. No grace period. AHA or Red Cross accepted at time of hire. Advanced Cardiac Life Support (ACLS)Within 30 days of hire. Within 90 days of hire. Pediatric Life Support (PALS)Within 30 days of hire. Within 90 days of hire. Trauma Nurse Core Curriculum (TNCC)Within 60 days of hire. Within 18 months of hire. Trauma Care After Resuscitation (TCAR)Within 60 days of hire. Within 18 months of hire. Neonatal Resuscitation Program (NRP)Within 30 days of hire. Within 60 days of hire. AWHONN INTERMEDIATE FHM (Fetal Heart Monitoring)Within 30 days of hire. Within 60 days of hire. STABLE (Neonatal Education)Within 30 days of hire. Within 60 days of hire. Work Schedule: 5 Days - 8 Hours Work Type: Full Time
Full Time
6/19/2025
Schertz, TX 78154
(16.4 miles)
Description IntroductionDo you want to join an organization that invests in you as a(an) Nurse Manager of Bone Marrow Transplant At Methodist Hospital, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.BenefitsMethodist Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.Free counseling services and resources for emotional, physical and financial wellbeing401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)Employee Stock Purchase Plan with 10% off HCA Healthcare stockFamily support through fertility and family building benefits with Progyny and adoption assistance.Referral services for child, elder and pet care, home and auto repair, event planning and moreConsumer discounts through Abenity and Consumer DiscountsRetirement readiness, rollover assistance services and preferred banking partnershipsEducation assistance (tuition, student loan, certification support, dependent scholarships)Colleague recognition programTime Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.Learn more about Employee BenefitsNote: Eligibility for benefits may vary by location.You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Nurse Manager of Bone Marrow Transplant like you to be a part of our team.Job Summary and QualificationsSeeking a Nurse Manager of Bone Marrow Transplant for Methodist Hospital who is responsible to the Director, Vice President and/or the Chief Nursing Officer for facilitating, coordinating and delegating the delivery of patient care to a defined group of patients during their entire hospitalization period. S/he is responsible 24 hours a day for the staffing and management of patient care in each of his/her units, for promoting the practice of professional nursing in a specified patient care area, and for the acquisition, development, and utilization of resources (human and material) needed to fulfill those responsibilities. S/he works cooperatively with administrators, physicians, staff, other managers and all customers of the Methodist Healthcare System to provide services, which consistently meet and exceed the expectations of their customers. This is accomplished by assessing and prioritizing opportunities to improve, plan and implement effective changes and evaluate outcomes of process improvement activities. The Nurse Manager models behavior consistent with Methodist Excellence and actively supports the Mission and Vision of the MHS; effectively maintains the hospital’s Standards of Care and Practice. We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply now!What You Will Do In Your Role: Builds and maintains a high functioning team. Provides leadership and direction for staffing their unit(s) in accordance with the organizational goals and objectives. Identifies modifications in staffing based on patient acuity and census.Manages personnel including interviewing, work allocation, orientation and training, staff development, problem resolution, evaluating performance, making recommendations for personnel actions, and motivation of employees to achieve peak performance. Is responsible for meeting unit productivity targets.Plans, organizes, facilitates and directs patient care delivered on the unit on a 24 hour basis in accordance with recognized and accepted internal (e.g. unit, department, and hospital) and external (e.g. TJC, Medicare, OSHA) standards.Develops and oversees the departmental scope of services and care.Develops and implements policies and procedures which relate to the particular nursing specialty and integrates standards of care into unit operations/collaborative care paths that support the provision of services.Directs processes to assess, improve and maintain the quality of patient care according to the hospital plan for quality improvement.What qualifications you will need:Graduate of an accredited diploma, associates, or baccalaureate degree nursing program.Three years clinical acute care RN experience.One year management experience.Current license to practice professional registered nursing in the state of TexasMethodist Hospital opened in 1963 as the first hospital in the now internationally acclaimed South Texas Medical Center. With over 900 beds, Methodist Hospital offers a broad range of specialties including cardiology, oncology, bone marrow transplants, emergency medicine, neurosciences, maternity care, gynecology and orthopedics. We are proud to be the largest provider of the lifesaving ECMO Program in San Antonio, are home to the largest robotics program in the world, and our Adult Blood Cancer and Stem Cell Transplant unit has become the first program to receive FACT Accreditation in North America. As the flagship hospital, and most comprehensive medical care facility of Methodist Healthcare, we appreciate the support and recognition we receive from the community. We’ve recently been named the No.1 Best Regional Hospital by the U.S. News and World Report for 2019-20. We pride ourselves on providing the highest quality of care possible for our patients, which is proven by our consecutive Grade A Leapfrog Hospital Safety scores. In addition, Methodist Hospital not only received a Primary Stroke Center designation from The Joint Commission, but has also received a Comprehensive Stroke Center Certification from DNV GL Healthcare, designating the facility as offering the most advanced stroke treatment available in a given geographic area. For more information, please visit our website at www.sahealth.com and select Methodist Hospital under Locations. "Good people beget good people."- Dr. Thomas Frist, Sr.HCA Healthcare Co-Founder We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Nurse Manager of Bone Marrow Transplant opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
Full Time
6/6/2025
Austin, TX 78737
(41.3 miles)
Nurse Supervisor Career Opportunity (Full-Time Nights) Leading with Heart: Your Journey Starts HereSeeking a career that's both personally enriching and professionally rewarding, close to home Encompass Health invites you into a welcoming space that feels like family, where your worth is embraced, fostering connections akin to lifelong friendships. As a Nurse Supervisor, envision making a profound impact within your community by providing essential care and guidance throughout patients' rehabilitation journeys. Your role is critical, offering leadership ensuring seamless implementation of procedures while delivering top-tier, compassionate, and tailored care. Embrace a team-driven, supportive environment that embraces joy in their work, providing access to cutting-edge technology and comprehensive benefits from day one. Join us and discover a career where your leadership shapes impactful care and personal fulfillment.A Glimpse into Our WorldWe're confident you'll feel the difference the moment you join our team. Being at Encompass Health means being associated with a growing national inpatient rehabilitation leader. We take pride in our career growth opportunities and the collaborative spirit of our team members, all united for the greater good of our patients. Our achievements, including being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For® Award, make us immensely proud.Benefits That Begin With YouOur benefits are designed to support your well-being and start on day one:Affordable medical, dental, and vision plans for both full-time and part-time employees and their families.Generous paid time off that accrues over time.Tuition reimbursement and continuous education opportunities for your professional growth.Company-matching 401(k) and employee stock purchase plans, securing your financial future.Flexible spending and health savings accounts tailored to your unique needs.A vibrant community of individuals who are passionate about what they do.Be the Nurse Supervisor You've Always Aspired to BeYour impactful journey involves:Assisting in the development and implementation of personalized patient care programs, policies, and procedures.Serving as the crucial liaison between administration, nursing management, and staff.Supervising nursing care, treatment, and services provided during assigned shifts or on a specific unit.Monitoring and managing staff, including on-the-spot feedback, annual evaluations, and administering performance counseling and disciplineAssuming patient care as needed and building meaningful relationships with patients by dedicating time to understand their physical, mental, and emotional needs for a successful recovery.Celebrating patient victories along the way.QualificationsCurrent RN licensure as required by state regulations.BLS certification with ACLS certification to be obtained within one year of starting position.CRRN certification to be obtained within a year of meeting the eligibility requirements.Bachelor's Degree in Nursing or related field preferred.Two years of recent experience in an inpatient hospital setting (within the last five years).Previous leadership role, such as charge nurse or lead capacity, where you were responsible for interim reporting, issue resolution, setting direction, and having accountability for patient and staff results.The Encompass Health WayWe proudly set the standard in care by leading with empathy, doing what's right, focusing on the positive, and standing stronger together. Encompass Health is a trusted leader in post-acute care with over 150 nationwide locations and a team of 36,000 exceptional individuals and growing!At Encompass Health, we celebrate and welcome diversity in our inclusive culture. We provide equal employment opportunities regardless of race, ethnicity, gender, sexual orientation, gender identity or expression, religion, national origin, color, creed, age, mental or physical disability, or any other protected classification.We're looking forward to meeting you, and we genuinely mean that. Join us on this remarkable journey!
Full Time
6/6/2025
Austin, TX 78737
(41.3 miles)
Nurse Supervisor Career Opportunity (Full-Time Nights) Leading with Heart: Your Journey Starts HereSeeking a career that's both personally enriching and professionally rewarding, close to home Encompass Health invites you into a welcoming space that feels like family, where your worth is embraced, fostering connections akin to lifelong friendships. As a Nurse Supervisor, envision making a profound impact within your community by providing essential care and guidance throughout patients' rehabilitation journeys. Your role is critical, offering leadership ensuring seamless implementation of procedures while delivering top-tier, compassionate, and tailored care. Embrace a team-driven, supportive environment that embraces joy in their work, providing access to cutting-edge technology and comprehensive benefits from day one. Join us and discover a career where your leadership shapes impactful care and personal fulfillment.A Glimpse into Our WorldWe're confident you'll feel the difference the moment you join our team. Being at Encompass Health means being associated with a growing national inpatient rehabilitation leader. We take pride in our career growth opportunities and the collaborative spirit of our team members, all united for the greater good of our patients. Our achievements, including being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For® Award, make us immensely proud.Benefits That Begin With YouOur benefits are designed to support your well-being and start on day one:Affordable medical, dental, and vision plans for both full-time and part-time employees and their families.Generous paid time off that accrues over time.Tuition reimbursement and continuous education opportunities for your professional growth.Company-matching 401(k) and employee stock purchase plans, securing your financial future.Flexible spending and health savings accounts tailored to your unique needs.A vibrant community of individuals who are passionate about what they do.Be the Nurse Supervisor You've Always Aspired to BeYour impactful journey involves:Assisting in the development and implementation of personalized patient care programs, policies, and procedures.Serving as the crucial liaison between administration, nursing management, and staff.Supervising nursing care, treatment, and services provided during assigned shifts or on a specific unit.Monitoring and managing staff, including on-the-spot feedback, annual evaluations, and administering performance counseling and disciplineAssuming patient care as needed and building meaningful relationships with patients by dedicating time to understand their physical, mental, and emotional needs for a successful recovery.Celebrating patient victories along the way.QualificationsCurrent RN licensure as required by state regulations.BLS certification with ACLS certification to be obtained within one year of starting position.CRRN certification to be obtained within a year of meeting the eligibility requirements.Bachelor's Degree in Nursing or related field preferred.Two years of recent experience in an inpatient hospital setting (within the last five years).Previous leadership role, such as charge nurse or lead capacity, where you were responsible for interim reporting, issue resolution, setting direction, and having accountability for patient and staff results.The Encompass Health WayWe proudly set the standard in care by leading with empathy, doing what's right, focusing on the positive, and standing stronger together. Encompass Health is a trusted leader in post-acute care with over 150 nationwide locations and a team of 36,000 exceptional individuals and growing!At Encompass Health, we celebrate and welcome diversity in our inclusive culture. We provide equal employment opportunities regardless of race, ethnicity, gender, sexual orientation, gender identity or expression, religion, national origin, color, creed, age, mental or physical disability, or any other protected classification.We're looking forward to meeting you, and we genuinely mean that. Join us on this remarkable journey!
Full Time
6/1/2025
Schertz, TX 78154
(16.4 miles)
Description IntroductionDo you have the PRN career opportunities as a RN Case Manager PRN you want with your current employer We have an exciting opportunity for you to join Methodist Hospital which is part of the nation's leading provider of healthcare services, HCA Healthcare.BenefitsMethodist Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation.Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.Fertility and family building benefits through ProgynyFree counseling services and resources for emotional, physical and financial wellbeingFamily support, including adoption assistance, child and elder care resources and consumer discounts401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)Employee Stock Purchase PlanRetirement readiness and rollover services and preferred banking partnershipsEducation assistance (tuition, student loan, certification support, dependent scholarships)Colleague recognition programTime Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)Learn more about Employee BenefitsNote: Eligibility for benefits may vary by location.Our teams are a committed, caring group of colleagues. Do you want to work as a(an) RN Case Manager PRN where your passion for creating positive patient interactions is valued If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!Job Summary and QualificationsThe Case Manager (CM) ensures high-quality, patient-centered care by managing Rehabilitative care to ensure optimum outcomes. The CM provides, coordinates, and directs care specific to the needs of each Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding departmental functions. The CM coordinates efforts within the Rehabilitation team.What you will do in this role:You will provide program orientation to patients/families/caregivers. Orientation will include the case manager's role, Rehab philosophy, and continued stay and discharge criteria. Orientation will also include Medicare and insurance benefits, grievance procedures, treatment plan process, and rights and responsibilities.You will act as the coordinator of patient/family/caregiver education. You will promote the participation of the patient/family/caregiver in team discussions related to plans, goals, and status. This will be conducted through Family Conferences and other interactions.You will ensure the implementation of the patient's treatment plan that supports the patient's strengths, abilities, needs, and preferences. You will facilitate the involvement of the patient throughout the rehabilitation process.You will document the findings of the Discharge Planning Evaluation (DPE) and psychosocial assessments. You will communicate the social, financial, or discharge needs and preferences of the patient/family/caregiver.You will assume accountability for promoting consistent, positive patient interactions that advance the agenda of unparalleled patient service.What qualifications you will need:Graduate of an accredited diploma, associates, or baccalaureate degree nursing program.Preferred: Bachelor of Science in Nursing RN License to practice as a professional registered nursing in the state of Texas or Active Multi-State RN Compact License. (Employees with RN Compact License are required to obtain Texas RN License within 90 days of hire date.) Minimum of 3 years clinical experience in area in which Case Management will be performed.Prefer at least one year experience in utilization review, resource management, discharge planning or case management.Methodist Hospital opened in 1963 as the first hospital in the now internationally acclaimed South Texas Medical Center. With over 900 beds, Methodist Hospital offers a broad range of specialties including cardiology, oncology, bone marrow transplants, emergency medicine, neurosciences, maternity care, gynecology and orthopedics. We are proud to be the largest provider of the lifesaving ECMO Program in San Antonio, are home to the largest robotics program in the world, and our Adult Blood Cancer and Stem Cell Transplant unit has become the first program to receive FACT Accreditation in North America. As the flagship hospital, and most comprehensive medical care facility of Methodist Healthcare, we appreciate the support and recognition we receive from the community. We’ve recently been named the No.1 Best Regional Hospital by the U.S. News and World Report for 2019-20. We pride ourselves on providing the highest quality of care possible for our patients, which is proven by our consecutive Grade A Leapfrog Hospital Safety scores. In addition, Methodist Hospital not only received a Primary Stroke Center designation from The Joint Commission, but has also received a Comprehensive Stroke Center Certification from DNV GL Healthcare, designating the facility as offering the most advanced stroke treatment available in a given geographic area. For more information, please visit our website at www.sahealth.com and select Methodist Hospital under Locations. "Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.HCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our RN Case Manager PRN opening. We review all applications. Qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status
Full Time
6/6/2025
San Antonio, TX 78207
(24.1 miles)
DescriptionSummary: The RN Supervisor is accountable for supervising the delivery of high-quality, cost-effective care to patients. Responsible in assisting the Director for analyzing, planning, implementing, evaluating, and communicating processes and programs which enhance, strengthen and integrate the services comprising the nursing department. Responsible for participation in the development and implementation of the service line strategic business plans; and for creating an environment, which continuously supports improvement of operational, financial, and clinical components. Assumes primary responsibility for effective supervision of nursing activities of assigned area(s). Assists management of financial and human resources to ensure services meet established quality and productivity standards. Provides feedback and assistance concerning customer satisfaction, staff development, and associate performance and satisfaction. The Supervisor is responsible for the daily operations of a Nursing department on a 24-hour basis. The Supervisor collaborates with other clinical and ancillary departments to meet organizational and department-specific Quality and Safety Measures, Community Values, Business Literacy, and Service Excellence goals. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Implementing and monitoring programs and practices for the delivery of safe and efficient quality nursing care for patients and their families. Ensuring consistent application of nursing services policies and standards throughout the organization. Monitoring patient outcomes and quality and effectiveness of nursing care. Overseeing the performance of teams; identifying and addressing staff training and development needs. Job Requirements: Education/Skills Bachelor of Science Degree in Nursing required for Magnet facilities, otherwise preferred. Experience 2 years of clinical patient care experience in a relevant setting. Previous Lead or Supervisor experience overseeing work of assigned units, preferred. Previous healthcare management experience preferred. Licenses, Registrations, or Certifications BLS required. RN License in state of employment or compact. Credential Grace Periods: If additional credentials are required per the Position Requirements section, a grace period to obtain the certification will apply, dependent on your experience level. Any Candidate/Associate with at least one year of acute care clinical experience in a similar service line within the past three years is considered anExperienced Associate. Any Candidate/Associatewho doesnothave at least one year of full-time acute care clinical experience in the same service line within the past three years is considered anExperienced Associate New to the Specialty. CredentialGrace Periods forExperienced AssociatesGrace Periods forNew Graduates & Experienced Associates New to the SpecialtyBasic Life Support (BLS)No grace period. AHA or Red Cross accepted at time of hire. No grace period. AHA or Red Cross accepted at time of hire. Advanced Cardiac Life Support (ACLS)Within 30 days of hire. Within 90 days of hire. Pediatric Life Support (PALS)Within 30 days of hire. Within 90 days of hire. Trauma Nurse Core Curriculum (TNCC)Within 60 days of hire. Within 18 months of hire. Trauma Care After Resuscitation (TCAR)Within 60 days of hire. Within 18 months of hire. Neonatal Resuscitation Program (NRP)Within 30 days of hire. Within 60 days of hire. AWHONN INTERMEDIATE FHM (Fetal Heart Monitoring)Within 30 days of hire. Within 60 days of hire. STABLE (Neonatal Education)Within 30 days of hire. Within 60 days of hire. Work Schedule: Varies Work Type: Full Time
Full Time
6/19/2025
San Antonio, TX 78251
(24.8 miles)
DescriptionSummary: The Utilization Management Nurse III is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services “CMS” Inpatient List). They effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment and are responsible for maintaining current and accurate knowledge regarding commercial and government payors and Joint Commission regulations and guidelines related to UM. This Nurse effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services. The Utilization Management Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. CHRISTUS Santa Rosa Hospital - Westover Hills (CSRH-WH) is a 150-bed hospital serving the fastest growing area of San Antonio. Specialized care includes orthopedic and surgical services, ICU, women’s services, a newborn nursery, comprehensive cardiovascular care from diagnostics to open heart surgery, vascular lab, sleep center, emergency services, the CHRISTUS Weight Loss Institute, wound care, rehabilitation, and more. The campus also boasts an Outpatient Imaging Center and three medical plazas, one of which houses our CHRISTUS Santa Rosa Family Medicine Residency Program and CHRISTUS Santa Rosa Family Health Center. Responsibilities: • Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. • Applies demonstrated clinical competency and judgment in order to perform comprehensive assessments of clinical information and treatment plans and apply medical necessity criteria in order to determine the appropriate level of care. • Resource/Utilization Management appropriateness: Assess assigned patient population for medical necessity, level of care, and appropriateness of setting and services. Utilizes MCG/InterQual Care Guidelines and/or health system-approved tools to track impact and variance. • Uses appropriate criteria sets for admission reviews, continued-to-stay reviews, outlier reviews, and clinical appropriateness recommendations. • Coordinate and facilitate correct identification of patient status. • Analyze the quality and comprehensiveness of documentation and collaborate with the physician and treatment team to obtain documentation needed to support the level of care. • Facilitates joint decision-making with the interdisciplinary team regarding any changes in the patient status and/or negative outcomes in patient responses. • Demonstrates, maintains, and applies current knowledge of regulatory requirements relative to the work process in order to ensure compliance, i. e. IMM, Code 44. • Demonstrate adherence to the CORE values of CHRISTUS. • Utilize independent scope of practice to identify, evaluate, and provide utilization review services for patients and analyze information supplied by physicians (or other clinical staff) to make timely review determinations, based on appropriate criteria and standards. • Take appropriate follow-up action when established criteria for utilization of services are not met. • Proactively refer cases to the physician advisor for medical necessity reviews, peer-to-peer reviews, and denial avoidance. • Effectively collaborate with the Interdisciplinary team including the Physician Advisor for secondary reviews. • Proactively review patients at the point of entry, prior to admission, to determine the medical necessity of a requested hospitalization and the appropriate level of care or placement for the patient. • Review surgery schedule to ensure planned surgeries are ordered in the appropriate status and that necessary authorization has been obtained as required by the payor or regulatory guidance (ie., CMS Inpatient Only List, Payor Prior Authorization matrix, etc.)• Regularly review patients who are in the hospital in Observation status to determine if the patient is appropriate for discharge or if conversion to inpatient status is appropriate. • Proactively identify and resolve issues regarding clinical appropriateness recommendations, coverage, and potential or actual payor denials. • Maintain consistent communication and exchange of information with payors as per payor or regulatory requirements to coordinate certification of hospital services. • Coordinate and facilitate patient care progression throughout the continuum and communicate and document to support medical necessity at each level of care. • Evaluate care administered by the interdisciplinary health care team and advocate for standards of practice. • Analyze assessment data to identify potential problems and formulate goals/outcomes. • Follows the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability ACT (HIPPA) designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI). • Attend scheduled department staff meetings and/or interdepartmental meetings as appropriate. • Possesses and demonstrates technology literacy and the ability to work in multiple technology systems. • Act as a catalyst for change in the organization; respond to change with flexibility and adaptability; demonstrate the ability to work together for change. • Translate strategies into action steps; monitor progress and achieve results. • Demonstrate the confidence, drive, and ability to face and overcome challenges and obstacles to achieve organizational goals. • Demonstrate competence to perform assigned responsibilities in a manner that meets the population-specific and developmental needs of patients served by the department. • Possess negotiating skills that support the ability to interact with physicians, nursing staff, administrative staff, discharge planners, and payers. • Excellent verbal and written communication skills, knowledge of clinical protocol, normative data, and health benefit plans, particularly coverage and limitation clauses. • Must adjust to frequently changing workloads and frequent interruptions. • May be asked to work overtime or take calls. • May be asked to travel to other facilities to assist as needed. • Actively participates in Multidisciplinary/Patient Care Progression Rounds. • Escalates cases as appropriate and per policy to Physician Advisors and/or CM Director. • Documents in the medical record per regulatory and department guidelines. • May be asked to assist with special projects. • May serve as a preceptor or orienter to new associates. • Assumes responsibility for professional growth and development. • Must have familiarity with criteria sets including InterQual and MCG preferred. • Must have excellent verbal and written communication. • Must have critical and analytical thinking skills. • Must have demonstrated clinical competency. • Other duties as assigned. Requirements: A. Education/Skills BSN required or demonstrated success as a Registered Nurse in the Utilization Management Nurse II role for at least five years at CHRISTUS Health on top of the required experience to include:Demonstrated leadership skills – formal or informalDemonstrated willingness to mentor team members including onboarding and orienting new associatesDemonstrated problem-solving skills Demonstrated positive approach in difficult and challenging situationsDemonstrated agent for change and change management B. Experience 5 years of experience in the clinical setting with at least 3 years in the acute care setting required. C. Licenses, Registrations, or Certifications RN License in state of employment or compact required. Certification in Case Management preferred. BLS preferred. Work Schedule: Varies Work Type: Part Time EEO is the law - click below for more information: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at .
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