Senior Case Manager
UnitedHealthcare
Registered Nurse OpportunityExplore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.The registered nurse provides nursing care to patients in an assigned clinical area and leadership on the unit, under the supervision of a Nurse Supervisor, or RN Coordinator. The RN applies clinical nursing knowledge and utilizes demonstrated skills to ensure the safety and comfort of patients and families according to legal, organizational and professional standards. The RN utilizes critical thinking to identify priorities and make judgments concerning basic and comprehensive needs of multiple patients in order facilitate appropriate and timely care.Primary Responsibilities:Clerical Review doctor's schedule, abstract as needed, print PVS for each patient and request other relevant information needed for patient's visit that dayPrepares and submits patient documents for scanningMonitor assigned in basket and complete work as needed-Overdue Results/LettersSchedule appointments and assist patient with specialty referrals and radiology testingProvide AVS and or pre-printed patient educational material as directed by providerProper disposal of confidential patient information -dailyFollows HIPAA policy and procedures regarding patient confidentialityDevelop patient teaching plansIdentify basic health related learning needs of patientPrepare and submit UR and other referrals as directed by the physicianCall in prescriptions as directed by the physicianPatient Care Utilize the nursing process. Act as an advocate to promote quality patient care. Critically analyze and integrate subjective and objective data regarding concerns and conditions both in direct encounters, computer, or telephoneMedication administration using the 7 rights, document, monitor, and report responseMonitor in basket for orders placed by physician and perform tasks that need to be completed; reports and accurately documents patient response. Manage workload in assigned departmental in basket to include: result notes, Rx requests, Rx response, orders, patient calls, over due results, canceled orders, expiring orders and patient advice requests.Telephone management: collect pertinent patient information to help identify health care needs and document in the medical record. Report information to physician for direction of care or provide care advice as appropriate to the situation.Perform CPR as needed and actively participates in management of emergency response (includes code blue and code orange teams)Document observations related to health status and report findingsTransport patient within facility as needed depending on acuity of patientRooms patients, performs testing, and assist physician as patient acuity warrants on arrival as rooms become availableDepartmental Maintenance Monitor supplies, medications and forms and notifies appropriate staff when reorder neededRemove and tag broken equipment and notifies coordinator, supervisor, or managerCleans assigned exam rooms daily and documents on logMonitors supplies for expiration date and restock to par levelsPerform sterilization of instruments and complete logs (assignment based on completion of sterilization class and delegation by appropriate nursing staff)Attends staff meetingsMaintain a clean and organized work area with a minimum of personal itemsQA-Regulatory Uses frequent hand washing or hand sanitizer (up to 10 times before have to wash hands with soap and water, unless hands visibly soiled) to prevent and control the spread of disease within the clinical settingComplete daily logs as assigned by nursing supervisor or coordinator: Waived testing (ie glucometer, urine dipstick and urine pregnancy logs) CLIA standardsRefrigerator and room temperature logsEye wash stationSterilizer logCrash cart logNarcotic logOther QA logsPerforms accurate, legal, & ethical documentationMaintain patient confidentialityPractice OSHA safety standards with proper disposal of biohazard wasteUses gloves and PPE as neededUses aseptic or sterile technique as neededVerify equipment has a current PM label before useIdentifies and reports potential barriers for the safe provision of patient care and maintains a safe patient environmentResponsible for personal growth and career development. Demonstrates competency during annual skills, Reports unsafe practicesParticipates in continuing nursing education programs and professional nursing organizationCustomer Service Works with patients to achieve excellent customer service and high levels of satisfactionPractices mutual respect among all members of the healthcare teamWorks with other staff to promote an efficient and effective healthcare teamDemonstrates Kelsey-Seybold's Mission and ValuesMeets both Clinic and individual Customer Service goals and standards by maintaining 90% or greater of excellence in customer serviceProvides age appropriate interactions. (See text box at end of this JD)Report and provide documentation of all complaints to coordinator, supervisor, manager or Clinic AdministratorUtilize warm transfer process when redirecting patient to ensure needs are metActively participate in service recovery when there is a failure in patient satisfactionTelephone Etiquette Answer and direct incoming calls to appropriate staff using a caring non-rushed toneIdentify clinic, department, name and job title in health care teamEnsure accurate information is obtained and communicated to the physician in writing via the medical recordFinancial: Demonstrates prudent use of resources. Minimizes wasteful actionsAssists with maintaining equipment according to manufacturer's recommendationReports to coordinator, supervisor, manager, or clinic administrator the need for over-time and obtains approvalQuality Improvement: Initiates, contributes and participates in the department and clinic process improvement plans. (PDSA)Provides department leadership and support for initiatives related to meeting AAAHC and other accrediting standardsFollows all safety standards for patients, employees and visitorsRecognizes and adheres to National Patient Safety GoalsImmunization Nurse: Demonstrates knowledge and skill needed to provide safe and effective immunization to facilitate patient care. Which includes but not limited to: Routine Immunization administrationForeign travel immunizations and consultationTB skin test application and readingAllergy immunotherapy injectionsMedication administrationsDocuments administrationsKnows how to access the appropriate resources when neededSeeks clarification or guidance with questions related to medication and immunization administrations from the physicianManage employee TB scheduleManage annual Flu inoculations for employeesAttends quarterly Immunization meetingsYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed
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