RN Supervisor, Utilization Review

Location: Austin, Texas US

Apply

Notice

This position is no longer posted.

Requisition Number: 19013512

Position Title:

External Description:

The Supervisor Utilization Review is responsible for daily oversight of the utilization review (UR) department. The Supervisor Utilization Review will provide direct assistance to the UR Managers by providing direction for complex cases, monitoring pending cases, reviewing and giving feedback to trainer regarding staff education opportunities, and acts as a liaison with interdepartmental communication.
 
WHAT IS EXPECTED (ESSENTIAL JOB FUNCTIONS): 
  • Function 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.
  •  Compile data for productivity reports on a weekly basis to support staffing decisions and quality metrics.
  •  Collaborate with Care Coordination Medical Director on patients not meeting criteria and informs Clinical Resource Manager/Director as needed.
  •  Complete daily staff assignments to ensure adequate service levels
  •  Monitor daily observation report and identify any potential issues
  •  Resolve escalations received from UR Nurses and staff
  •  Conduct quality reviews as assigned
  •  Respond to UR questions from staff and stakeholders
  •  Serve as a Subject Matter Expert (SME) for UR workflow issues, complex cases, denials and internal/external customers
The ideal candidate is self-motivated, has strong written and verbal communication skills, able to prioritize multiple issues, has excellent organizational skills, and has the ability to track multiple projects/tasks and follow through as needed.

This position is intended to supervise the Utilization Review operations and staff RNs for Austin, Round Rock and Marble Falls regions. Will be able to work remotely a majority of the time; though we require the incumbent to reside in the Central Texas Region for regional travel purposes as needed. 

�  Location/Facility ï¿½ Baylor Scott & White Health - Austin, Round Rock, Marble Falls (Work from home and travel within the Region as needed) 
For more information on the facility, please click our Locations link.
�  Specialty/Department/Practice � Utilization Review / Case Management 
�  Shift/Schedule ï¿½ Full-time / Mon-Fri
�  Benefits � Our competitive benefits package includes*:
�  Immediate 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 level.

Baylor Scott & White Health (BSWH)  is the largest not-for-profit health care system in Texas and one of the largest in the United States.  With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation�s exemplary health care organizations.  Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it�s accepting a calling!


  • Bachelor�s Degree - Graduate of an accredited nursing program
  • 4+ years experience
  • Registered Nurse (RN) License

City:

State:

Community / Marketing Title: RN Supervisor, Utilization Review

Company Profile:

Location_formattedLocationLong: Austin, Texas US

CountryEEOText_Description: 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. To view the most recent EEO is the Law Poster, click here.

As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviors 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. To view the most recent EEO is the Law Poster, click here.