Job Details

ID #45515550
State Texas
City Dallas / fort worth
Full-time
Salary USD TBD TBD
Source Baylor Scott & White Health
Showed 2022-09-07
Date 2022-09-08
Deadline 2022-11-06
Category Et cetera
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Supervisor Utilization Review RN (Remote)

Texas, Dallas / fort worth, 75201 Dallas / fort worth USA

Vacancy expired!

JOB SUMMARYThe Supervisor Utilization Review RN is responsible for daily oversight of the Utilization Review (UR) function, and provides direction for complex cases, monitors pending cases, reviews and gives feedback to trainers regarding staff education opportunities, and acts as a liaison with interdepartmental communication.ESSENTIAL FUNCTIONS OF THE ROLEFunctions as a working Supervisor for Utilization Review Department, through the monitoring of staff workload, creating assignments, reviewing productivity, conducting quality reviews, advising with peer-to-peer appeals, and advising with denial research.Compiles data for productivity reports on a weekly basis to support staffing decisions and quality metrics.Collaboratse with Care Coordination Medical Director on patients not meeting criteria and informs Clinical Resource Manager/Director as needed.Completes daily staff assignments to ensure adequate service levelsMonitors daily observation report and identify any potential issuesResolves escalations received from UR Nurses and staffConducts quality reviews as assignedResponds to UR questions from staff and stakeholdersServes as a Subject Matter Expert (SME) for UR workflow issues, complex cases, denials and internal/external customersKEY SUCCESS FACTORSAbility to assist individuals in recognizing and solving problems.Ability to supervise, motivate, and provide guidance to staff to ensure their clinical competency.Strong written and verbal communication skills.Ability to work effectively with employees at all levels within the organization, including physician and executive leadership.Knowledge of discharge planning, case management and utilization review.Ability to make tactical decisions around the allocation and direction of the work of supervised employees using established guidelines, policies and/or procedures.Ability to make effective hiring and termination recommendations.Ability to train, and evaluate performance of supervised staff.General computer skills, including but not limited to: Microsoft Office, information security, scheduling and payroll systems, electronic medical documentation, and email.BENEFITSOur competitive benefits package includes the followingImmediate eligibility for health and welfare benefits

401(k) savings plan with dollar-for-dollar match up to 5%

Tuition Reimbursement

PTO accrual beginning Day 1

Note: Benefits may vary based upon position type and/or levelQUALIFICATIONSEDUCATION - Associate's

MAJOR - Nursing

EXPERIENCE - 4 Years of Experience

As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Vacancy expired!

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