RN Manager

5 days ago

Austin, Texas, United States Ascension Seton Northwest Full time
Job Summary

We are seeking a highly skilled and experienced RN Manager to lead our Utilization Review and Optimization team at Ascension Seton Northwest. As a key member of our clinical leadership team, you will be responsible for managing effective utilization review processes, collaborating with directors to develop quality review programs, and overseeing day-to-day operations of the department.

Key Responsibilities
  • Manage effective utilization review processes, including management of patient statusing processes and monitoring of medical necessity review functions for assigned sites.
  • Collaborate with the director to develop and implement quality review programs and key performance indicators for all utilization review activities.
  • Interact with medical, nursing, and executive leadership to facilitate quality-based, cost-effective patient statusing in the most appropriate setting, in compliance with regulatory and revenue cycle requirements.
  • Oversee day-to-day operations of the department and assist with the budgeting process.
  • Serve as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation.
  • Conduct hiring, training, directing, development, and evaluation of staff.
Requirements
  • Licensure / Certification / Registration:
    • Registered Nurse credentialed from the Texas Board of Nursing obtained prior to hire date or job transfer date required.
  • Education:
    • Required professional licensure/certification AND 3 years of experience and 1 year of cumulative leadership experience required.
  • Work Experience:
    • Two years of related experience is required.
  • Additional Preferences:
    • Utilization Review management experience required.

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