Registered Nurse (RN) - House Supervisor - $35-55 per hour
Company: Baylor Scott & White Health
Location: Garland
Posted on: August 6, 2022
Job Description:
Baylor Scott & White Health is seeking a Registered Nurse (RN)
House Supervisor for a nursing job in Dallas, Texas.Job Description
& Requirements
- Specialty: House Supervisor
- Discipline: RN
- Start Date: ASAP
- Duration: Ongoing
- 36 hours per week
- Shift: 12 hours
- Employment Type: Permanent
JOB SUMMARY
The Supervisor, Denial Resource Center provides direction regarding
cases submitted to the Denial Resource Center (DRC) for clinical
appeal. The Supervisor provides guidance to appeal writers and
administrative assistants on daily workflow and ensures appropriate
distribution of workload and cases.
ESSENTIAL FUNCTIONS OF THE ROLE
- Supervises Denial Resource Center (DRC) RNs and Administrative
Assistants through the monitoring of staff workload, developing
staff assignments, and reviewing of productivity. Handles
escalations from DRC RNs.
- Conducts quality reviews, advises with peer-to-peer appeals and
denial research.
- Analyzes deadline report and worklists and assigns high
priority, special cause accounts. Evaluates incoming cases for
readiness for appeal and appropriate expertise assigned for
appeal.
- Recommends and implements quality improvement
initiatives
- Supports orientation of new staff and ongoing training
- Reviews cases for appropriateness for referral for external
appeal such as ALJ, THHSC, VA complaints. Writes clinical appeals,
as needed.
- Serves as a resource for staff related to complex
accounts.
- Interfaces with Collectors, Administrative Assistants and
Appeal Writers to assess effectiveness of work processes and acts
upon opportunities for improvement with account handoffs and
communication regarding cases.
- Serves as resource for IT and training on BSWH systems used in
the DRC (e.g. Midas, AEOS, EPIC, Allscripts, PatCom, Nuance,
Microsoft Office Suite, etc.).
- Prepares reports as assigned for use within the department and
external customers. This includes but is not limited to routine
reports for verifying status of accounts using MIDAS, TRAC,
AEOS.
KEY SUCCESS FACTORS
- Understands commercial and government regulations for
reimbursement including, but not limited to: InterQual, RAC/MAC,
Clinical Policy Bulletins, national and local coverage
determinations, CMS admission status requirements, TJC conditions
of participation, CMS appeals process, including Administrative Law
Judge.
- Knowledge and understanding of nursing and patient care
standards and procedures.
- Knowledge of laws, rules and regulations; standards and
guidelines of certifying and accrediting bodies; hospital and
department/unit standards, protocols, policies and procedures
governing the provision of nursing care applicable to the area of
assignment.
- Knowledge of medical terminology; principles and practices of
health promotion, risk reduction, illness and disease prevention
and management; medications and drugs, common dosages, their
physical and physiological effects, and possible adverse
reactions.
- Knowledge of medical and professional nursing ethics and
patient privacy rights.
- Must be able to communicate thoughts clearly, both verbally and
in writing.
- Interpersonal skills to interact with a wide-range of
constituencies.
- Must have critical thinking and problem-solving
skills.
- Ability to observe changes in the medical condition of patients
and effectively communicate these changes to other nursing staff
members and physicians/providers.
- Ability to provide age-specific, quality, patient-centered care
to all patients through the nursing process and standards of
nursing practice with sensitivity and respect for the diversity of
human experience and to develop, evaluate, implement and, as
necessary, modify a patient care plan to meet the needs of
individual patients.
- Ability to make tactical decisions around the allocation and
direction of the work of supervised employees using established
guidelines, policies and/or procedures.
- Ability to make effective hiring and termination
recommendations.
- Ability to train and evaluate performance of supervised
staff.
- General computer skills, including but not limited to:
Microsoft Office, information security, scheduling and payroll
systems, electronic medical documentation, and email.
- ACM or CCM license preferred.
BENEFITS
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to
5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
--QUALIFICATIONS
- EDUCATION - Associate's
- MAJOR - Nursing
- EXPERIENCE - 3 Years of Experience
- CERTIFICATION/LICENSE/REGISTRATION -
- Registered Nurse (RN)
Baylor Scott and White Job ID #0. Pay package is based on 12 hour
shifts and 36 hours per week (subject to confirmation). Posted job
title: Supervisor Denial Resource Center RN (remote)About Baylor
Scott & White HealthBaylor Scott & White Health is the largest
not-for-profit health care system in the state of Texas.Benefits
- Holiday Pay
- Continuing Education
- 401k retirement plan
- Sick pay
- Wellness and fitness programs
- Referral bonus
- Employee assistance programs
- Medical benefits
- Dental benefits
- Vision benefits
- Benefits start day 1
- License and certification reimbursement
- Life insurance
- Discount program
Keywords: Baylor Scott & White Health, Garland , Registered Nurse (RN) - House Supervisor - $35-55 per hour, Healthcare , Garland, Texas
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