Kelsey-Seybold

Supervisor RN-Utilization Review

US-TX-Pearland
6 days ago
Job ID
2017-18080
Category
Nursing

Overview

 

Supervisor RN-Utilization Review

Location: Pearland Administrative Office
Job Type: Full-Time
Department:UR Health Services

 

COMPANY PROFILE

Kelsey-Seybold Clinic. Your Doctors for Life.

Since 1949, Kelsey-Seybold Clinic has served its patients with one goal in mind – combine the expertise of physicians in a variety of medical specialties, with the close personal care of a family doctor. Kelsey-Seybold is Houston’s largest community-based physician group, caring for more than 400,000 patients. With 21 clinic locations, we are growing to meet the health care needs of our diverse patient population. Our mission is to provide our team members with exceptional opportunities for professional and personal growth.​​

 

JOB SUMMARY

The UR Supervisor supervises and directs the pre-certification process and staff assigned to work groups to ensure compliance with the delegated utilization management responsibilities and utilization review license. The Supervisor is responsible for the daily operations of the UR Department and works with the Manager of Utilization Review/Health Services to develop and refine processes and meet reporting requirements. The UR Supervisor is a facilitator of communication with clinic, payers, medical director and other customers.

 

 

EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS

(A = basics; B = preferred)

 

Education:

A. Registered Nurse, CEU requirements

 

Experience:

A. 5 years varied medical/surgical experience. 3 years UR or case management experience. 

Computer and Coding experience

 

Licenses:

A. TX RN license, drivers license

 

Special Skills:

A.  2 years previous supervisory or management experience. Good organizational and communication skills.

 

Other:

A.  HMO, PPO and POS Insurance knowledge.

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