Utilization Review Assistant Jobs in Houston, TX

Explore 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 vocational nurse provides nursing care to patients in an assigned clinical area, under the supervision of a Nurse Supervisor, or Nurse Coordinator. The LVN 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 LVN identifies priorities and makes judgments concerning basic needs of multiple patients in order to organize care.

Work Hours: 9am-6pm Monday-Friday.

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 day
  • Prepares and submits patient documents for scanning
  • Monitor assigned in basket and complete work as needed-Overdue Results/Letters
  • Schedule appointments and assist patient with specialty referrals and radiology testing
  • Provide pre-printed patient educational material as directed by provider
  • Proper disposal of confidential patient information -daily
  • Follows HIPAA policy and procedures regarding patient confidentiality
  • Reinforce patient teaching
  • Identify basic health related learning needs of patient
  • Prepare and submit UR and other referrals as directed by the physician
  • Call in prescriptions as directed by the physician
• Patient Care:
  • Monitor in basket for orders placed by physician and perform tasks that need to be completed (i.e. waived testing, EKG's, specimen collection, spirometry, hearing, vision); reports and accurately documents patient response
  • Document observations related to health status and report findings
  • Rooms patients on arrival as rooms become available:
  • Obtain patient's demographic information, history, chief complaint
  • Verify patient allergies and documents vital signs per policy
  • Reconcile medication list with patient at each visit and update preferred pharmacy
  • Documents patient education to include patient's learning method, preferred language, if needs an interpreter and ability to read, and include appropriate education for office visit
  • Complete questionnaires when appropriate (ie lead, TB, flu, New Patient Intake)
  • Prepares patient and room for physician visit
  • Assist physician with preparing patient for examination & minor office procedures
  • Perform activities of daily living on patients as needed (ie emptying ostomy bags, changing adult and pediatric diapers)
  • Transport patient within facility as needed
  • Performs/Obtains: EKG, Waived Testing (Capillary Blood Glucose, Hemocult, Urine Pregnancy), Hearing & Vision Testing, Sterilization of Instruments, and procedures. Report and document patient response
  • Collects & prepares lab specimens (Urinalysis, Pap Smear, Biopsy, Cultures) and transports to lab
  • Perform CPR as needed and assist during times of emergency
  • Medication administration using the 7 rights, document, monitor, and report response.
  • Telephone management: collect pertinent patient information to help determine health care need and document in the medical record. Report information to physician for direction
• Departmental Maintenance:
  • Monitor supplies, medications and forms and notifies appropriate staff when reorder needed
  • Remove and tag broken equipment and notifies coordinator, supervisor, or manager
  • Cleans exam rooms daily and documents on log
  • Monitors supplies for expiration date and restock to par levels
  • Perform sterilization of instruments and complete logs (assignment based on completion of sterilization class and delegation by appropriate nursing staff)
  • Attends staff meetings
  • Maintain a clean and organized work area with a minimum of personal items
• QA-Regulatory:
  • Complete daily logs as assigned by nursing supervisor or coordinator:
  • Waived testing (ie glucometer, urine dipstick and urine pregnancy logs) CLIA standards
  • Refrigerator and room temperature logs
  • Eye wash station
  • Other QA logs
  • Performs accurate, legal, & ethical documentation
  • Maintain patient confidentiality
  • Practice OSHA safety standards with proper disposal of biohazard waste
  • 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 setting
  • Uses gloves and PPE as needed
  • Uses aseptic or sterile technique as needed
  • Verify equipment has a current PM label before use
  • Identifies and reports potential barriers for the safe provision of patient care and maintains a safe patient environment
  • Responsible for personal growth and career development. Demonstrates competency during annual skills, Reports unsafe practices. Participates in continuing nursing education programs
• Customer Service:
  • Works with patients to achieve excellent customer service and high levels of satisfaction
  • Practices mutual respect among all members of the healthcare team
  • Works with other staff to promote an efficient and effective healthcare team
  • Demonstrates Kelsey-Seybold's Mission and Values
  • Meets both Clinic and individual Customer Service goals and standards by maintaining 90% or greater of excellence in customer service
  • Provides age appropriate interactions
  • Telephone Etiquette
  • Answer and direct incoming calls to appropriate staff using a caring non-rushed tone
  • Identify clinic, department, name and job title in health care team Ensure accurate information is obtained and communicated to the physician
  • Report and provide documentation of all complaints to coordinator, supervisor, manager or Clinic Administrator Utilize warm transfer process when redirecting patient to ensure needs are met
• Financial:
  • Demonstrates prudent use of resources. Minimizes wasteful actions
  • Assists with maintaining equipment according to manufacturer's recommendation
  • Reports to coordinator, supervisor, manager, or clinic administrator the need for over-time and obtains approval
• Quality Improvement:
  • Contributes and participates in the department and clinic process improvement plans. (PDSA)
  • Supports and provides department leadership for initiatives related to meeting AAAHC and other accrediting standards
  • Follows all safety standards for patients, employees and visitors
  • Recognizes and adheres to National Patient Safety Goals
• Immunization Nurse: Demonstrates knowledge and skill needed to provide safe and effective immunization to facilitate patient care. Which includes but not limited to:
  • Routine Immunization administration
  • Foreign travel immunizations and consultation
  • TB skin test application and reading
  • Allergy immunotherapy injections
  • Medication administrations
  • Documents administrations
  • Knows how to access the a resource RN when needed
  • Seeks clarification or guidance with questions related to medication and immunization administrations from the physician
  • Other
     

You'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 in your role as well as provide development for other roles you may be interested in. 
 

Required Qualifications:

• Graduate from an approved vocational nursing program
• Current and valid Texas LVN license
• BLS through the American Heart Association
• 6 months in a clinical area or successful completion of a KSC
• Computer experience
• Ability to use equipment and related supplies for selected patient population for the assigned clinical area

Preferred Qualifications:

• LVN Residency program
• EPIC experience
• Windows bases computer skills

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.