Surgical Care Affiliates

  • Utilization Review Coordinator - RN

    Job Location US-TX-Austin
    Type
    Full-Time
    # of Openings
    1
  • Overview

    SCA, a leader in the outpatient surgery industry, strategically partners with health plans, medical groups and health systems across the country to develop and optimize surgical facilities. SCA operates more than 210 surgical facilities, including ambulatory surgery centers and surgical hospitals, in partnership with approximately 7,500 physicians. For more information on SCA, visit www.scasurgery.com

     

    Facility Description:

    Northwest Hills Surgical Hospital, and its affiliated physicians and partners, are committed to delivering high quality surgical services to ensure superior patient experiences and clinical outcomes. We are dedicated to providing exceptional care in a fun, friendly, professional and safe environment. Our Staff is critical to our success. Northwest Hills Surgical Hospital is an eight bed general acute care hospital offering inpatient and outpatient procedures. We specialize in Pain Management, Ophthalmology, General Surgery, Plastic Surgery, Gastroenterology, Orthopedics, and Podiatry.

     

    For more information on Northwest Hills Surgical Hospital, visit www.northwesthillssurgical.com

    Accountabilities / Responsibilities

    Registered Nurse / Utilization Review / Case Manager

    The Utilization Review RN position purpose is to serve as the interdisciplinary team coordinator, facilitate the delivery of services to patients and their families, manage the financial resources of the patient by acting as a liaison to the payor, assume cost effectiveness of treatment provided by the team, facilitate and coordinate the discharge planning process, serve as the patient and family advocate, coordinate and direct effective communication regarding the patient’s care with the nursing team, and ensure patient meets medical necessity based on criteria.

    This is a multifaceted position that offers a great learning opportunity with training and support to expand your knowledge in this sector of nursing.

     

    Key Responsibilities:

    • Ability to communicate effectively, both orally and in writing, with a variety of individuals, including patients, families, payors, physicians, community agencies, etc.
    • Working knowledge of the insurance payors and the insurance industry
    • Functions as a liaison to the payor to manage the financial resources and ensure effective communication regarding the patients expected treatment process, progress and discharge plan.
    • Able to achieve clearly defined objectives, position responsibilities, patient’ goals and demonstrate accountability, decision making, and time management.
    • Functions as the interdisciplinary team coordinator to ensure the timely provision of cost effective quality care.
    • Knowledge of current matters relating to Utilization Review and Case Management

    Qualifications

    • Graduate of an Accredited School of Nursing, Current Registered Nurse License in the state of Texas or compact, BLS and ACLS certifications, with a Bachelor of Science in nursing preferred.
    • At least five years of clinical (direct patient care) experience and utilization review/case management experience with experience in determining medical necessity in accordance with specified hospital guidelines.

    Please send resumes to barbara.kenney@scasurgery.com

    2019-5049

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