Utilization Mgmt Clinical RN

 
Position: Utilization Mgmt Clinical RN

Job ID: 145123

Location: US-TX-Bellaire

Department: Utilization Management

Talent Area: Registered Nurse

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: Days

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

Summary:

We are searching for a Clinical Nurse Coordinator, someone who can work well in a fast-paced healthcare environment. In this position you’ll manage daily clinical and personnel activities for the Department. You will also participate and coordinate the delivery of high quality, family centered and developmentally appropriate patient care.

 

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Responsibilities :

  • Coordinates visits with physicians, ensures appropriate consultations in hospital by working with the Coordinators 
  • Coordinates visits with diagnostic imaging department and appropriate pediatric sub-specialists 
  • Provides follow-up to referring physicians through written documentation based on recommendations for clinical management discussed at the weekly multidisciplinary conference 
  • Assists the coordinators in providing education to patients, families, communities and other hospital/medical staff concerning various aspects of care 
  • Provides appropriate educational material for families and staff. Assists other coordinators with Formulating implementation, and documentation teaching plans for patients 
  • Assists marketing team to create awareness of the services associated with the department and promote brand identity 
  • Coordinates nursing care of patients across various departments and sub-specialty services by demonstrating commitment to team, flexibility, professional interpersonal, communication, critical thinking, and customer service skills 
  • Ensures an accurate, current, and comprehensive database of all sub--specialty patients is maintained 
  • Ensures surgery packets are available to patients by working with surgery 
  • Maintains data to assist with patient care 
  • Develops and maintains procedures for all patients seen in the department 
  • Acts as a patient advocate in maintaining communication and promoting continuity of patient care within department, multidisciplinary teams, and referring/community physicians 
  • Supports staff in the development of their schedules and monitors effectiveness of process on staffing needs 
  • Participates in the decision-making processes for hiring new employees


Qualifications:

  • Bachelor of Science in Nursing, Associate Degree in Nursing, or Diploma in Nursing (Bachelor of Science in Nursing is preferred) 
  • Current RN license in the state of Texas 
  • A minimum of three (3) years of nursing experience 
  • Utilization Management experience is preferred
  • Experience working with a MCO is preferred
  • Experience dealing with Starkids, Chip, or SSI population is highly preferred.


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