Utilization Management Resource Nurse

Harris Health is a nationally recognized health system comprising three teaching hospitals and an extensive network of ambulatory care centers serving the people of Harris County, Texas, since 1966. Staffed by the faculty, fellows and residents from two nationally ranked medical schools, Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth), Harris Health is the first healthcare system in Houston to receive the prestigious National Committee for Quality Assurance (NCQA) designation for its network of patient-centered medical homes.

Each year, Harris Health provides more than 1.8 million total outpatient visits through its more than 40 ambulatory care facilities. Additionally, Harris Health sees more than 177,000 emergency visits at its Level 1 and Level 3 trauma centers and 35,000 hospital admissions through its three hospitals: Ben Taub, LBJ and Quentin Mease.

Established by voter referendum to enhance the level of charity care available in the community, Harris Health System has often received national recognition for serving those in need and for its achievements in operational excellence, such as being named to the 2011, 2012, 2013 and 2014 Most Wired Hospitals lists by the American Hospital Associations Hospitals & Health Networks magazine.

Additionally, Harris Health System is pleased that each of its three hospitals Ben Taub, Lyndon B. Johnson and Quentin Mease achieved Pathway to Excellence designation by the American Nurses Credentialing Center.

The Utilization Management Resource Nurse (UMRN) assesses, plans, develops, implements and evaluates education activities, competency validation, care coordination, programs and initiatives for utilization management and clinical case management services across the system. The UMRN demonstrates expert case management knowledge and skills, effective teaching/education skills, and supports system level utilization and clinical case management initiatives.

The UMRN provides leadership within the system including: quality improvement activities; supports effective human resources management; and supports resource accountability. The UMRN exemplifies professionalism and promotes a customer-friendly environment by utilizing Service FIRST behaviors in interactions with leadership, pavilion case managers, physicians, and other internal and external stakeholders.

The UMRN is responsible for facilitating an environment that cultivates the collaborative interdisciplinary process of effective utilization and clinical case management. As a member of the utilization management leadership team, the UMRN establishes a setting that supports professional case management practice and empowers staff to provide safe, cost-effective, compassionate and efficient care coordination and resource utilization in collaboration with all health care disciplines. The UMRN facilitates enculturation of the Harris Health System Clinical Case Management platform and its goals to achieve targeted outcomes at the pavilion and system levels. The UMRN supports compliance with standards established by professional clinical case management organizations; national, state, and local regulatory agencies and institutional policies and procedures. The UMRN holds high standards of integrity and ethical behavior, mentors others, role models professionalism, and participates in activities such as professional organizations, research, and the community.

MINIMUM QUALIFICATIONS:

1. Education/Licensure/Specialized Training:

a. Education:
Graduation from an accredited School of Nursing with a Masters degree in Nursing or related field is required.

b. Licensure/Certification:
Licensed to practice nursing in the State of Texas.
Clinical Case Management specialty certification required.

2. Work Experience: Five (5) years of work experience in clinical case management is required.

3. Management/Experience: Two (years) related clinical/leadership experience is required.

SPECIAL REQUIREMENTS:

1. Communication Skills:
Above Average Verbal: (Heavy Public Contact)
Exceptional Verbal:(e.g., Public Speaking)
Bilingual Skills Required: No
Writing /Composing: (Correspondence/ Reports)

2.Other Skills
Analytical Design; Medical Terms; PC; Research; Statistical;Word Proc

3.Advanced Education:
Advance Training: Specialty: Certification in Clinical Case Management
Bachelors Degree Major: Nursing
Masters Degree Major:Nursing or related field

4.Work Schedule:
Weekends; Holidays; Flexible; On Call

Harris Health System benefits program is designed to provide you with more flexibility and choices in meeting your specific needs. Harris Health System benefits program allows you to protect your income in case of illness, death and disability, and to help you save for retirement.

It is the policy of Harris Health System to provide equal opportunity for all applicants for employment regardless political affiliation, race, color, national origin, age, sex, religious creed or disability. Applicants may request any reasonable accommodation(s) to participate in the application process.

Nursing