Utilization Management Resource Nurse

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