Coordinator Utilization Management in San Antonio, Texas, United States
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Methodist Hospital Specialty and Transplant

Coordinator Utilization Management

San Antonio, TX, United States
Full-time  Days 7-10 Hrs/Wkdays Only 
Category: Registered Nurse • Job ID: 269565

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Description

Introduction

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Coordinator Utilization Management with Methodist Hospital Specialty and Transplant you can be a part of an organization that is devoted to giving back!

Benefits

Methodist Hospital Specialty and Transplant, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation.
  • Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
  • Fertility and family building benefits through Progyny
  • Free counseling services and resources for emotional, physical and financial wellbeing
  • Family support, including adoption assistance, child and elder care resources and consumer discounts
  • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  • Employee Stock Purchase Plan
  • Retirement readiness and rollover services and preferred banking partnerships
  • Education assistance (tuition, student loan, certification support, dependent scholarships)
  • Colleague recognition program
  • Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the Methodist Hospital Specialty and Transplant family! We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Coordinator Utilization Management to help us reach our goals. Unlock your potential!

Job Summary and Qualifications

The Manager serves as utilization management liaison between Utilization Review Committee, Quality Management Committee, Administration, Finance, Case Management, Medical Staff and Third Party Agencies; assists with integration of Utilization Management principles to maximize quality of clinical care, documentation, utilization of resources and reimbursement.  

What you will do in this role:

  • Develops and maintains the Utilization Management systems for Behavioral Health Services to ensure the successful and professional management of the case management system for all levels of the continuum of behavioral health services.  
  •  Consults on a regular basis with all Utilization Management personnel and provides periodic in-servicing on clinical and procedural materials and issues for all relevant personnel
  •  Coordinates all Behavioral Health Services Utilization Management activities with the Methodist Healthcare System Case Management. Provides timely data and reports to Methodist Healthcare System on Behavioral Health Utilization Management/Case Management and policies and procedures.  
  •  Follows up on Methodist Healthcare System Utilization Management/Case Management issues that relate to Behavioral Health and provide positive feedback.
  • Monitors and ensures compliance of documentation requirements in the medical records of the behavioral health patients in all levels of care.  
  •  Monitors customer service process and the timeliness, responsiveness, professionalism and courtesy of Utilization Management staff.  

What qualifications you will need:
  • Five (5) years experience as a manager of utilization management/case management in a behavioral health system or managed care company to include familiarity with the full continuum of care to include inpatient, partial hospitalization, intensive outpatient and traditional outpatient services.
  • Must be familiar with clinical pathways, level of care admission and continued stay criteria, length of stay parameters and denial management.  
  • Registered Nurse in the state of Texas

This role requires you to be fully vaccinated for COVID-19 based on local, state and /or federal law or regulations (unless a medical or religious exemption is approved).

Methodist Specialty and Transplant Hospital has been nationally recognized for its record setting kidney, liver and pancreas transplant programs. The hospital is home to the Texas Transplant Institute. We are the largest living donor kidney transplant program in the US. In 2019 the center reached a major milestone by performing 231 living donor kidney transplants in a single year. This set a new national record, 65 more transplants than the second center on the list. This is acknowledged in the United Network of Organ Sharing database.

"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

Be a part of an organization that invests in you! We are reviewing applications for our Coordinator Utilization Management opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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