University Health is Bexar County and South Texas' first health system to earn Magnet status from the American Nurses Credentialing Center (ANCC). Magnet hospitals and health systems offer patients reassurance that they are being cared for by a team with a proven track record for providing excellent care and positive outcomes for their patients.

What sets us apart?

• Most up-to-date advancements in nursing
• Level I Trauma Center
• Teaching Hospital
• Nurse Residency Program
• RN Loan Repayment Program Nationally certified nursing staff
• Regionally, nationally and internationally recognized
• Seeking a Cardiac Device RN who has as a specialized skill set and will provide both technical and clinical component to ensure the patient care meets established procedures and quality standards around Electrophysiology relative to CIED’s (Cardiac Implantable Electronic Devices). The Device RN will be independently accountable for the management and coordination of care of patients with devices in the inpatient and outpatient setting.

POSITION SUMMARY AND RESPONSIBILITIES

Seeking a Cardiac Device RN who has as a specialized skill set and will provide both technical and clinical component to ensure the patient care meets established procedures and quality standards around Electrophysiology relative to CIED’s (Cardiac Implantable Electronic Devices). The Device RN will be independently accountable for the management and coordination of care of patients with devices in the inpatient and outpatient setting.

EDUCATION/EXPERIENCE

Graduate of an accredited school of professional nursing required. Bachelor's degree in Nursing (BSN) preferred. Minimum two (2) years of clinical nursing, utilization management, managed care, prior authorization, concurrent review, appeals, or case management experience required.

Working knowledge of:

• NCQA Utilization Management Standards
• URAC Utilization Management Standards
• CMS Managed Care requirements
• Texas Medicaid Managed Care regulations
• Medicare requirements, Medical necessity review criteria (InterQual®, MCG®, or organization-approved criteria)
• ICD-10-CM, CPT, and HCPCS coding principles
• Utilization management operations, including prior authorization, concurrent review, retrospective review, appeals, and denial management
• Regulatory compliance, documentation standards, and turnaround time requirements.

Experience reviewing Medicaid, Medicare, Marketplace, Commercial, CHIP, Dual Eligible Special Needs Plans (D-SNP), or other government-sponsored healthcare programs preferred. Experience in a managed care organization, health plan, delegated entity, or other regulated healthcare environment preferred.

LICENSURE
Current unrestricted Registered Nurse (RN) license issued by the Texas Board of Nursing is required. A Magnet recognized national certification is highly desirable.
Certified Case Manager (CCM), Accredited Case Manager (ACM), or Utilization Management-related certification preferred.