MD Anderson Cancer Center Patient Access Coordinator (Utilization Review Nurse) - The Woodlands in Woodlands, Texas

Patient Access Coordinator (Utilization Review Nurse) - The Woodlands

Location: United States, Texas, Woodlands, Woodlands at https://mdanderson.referrals.selectminds.com/jobs/11648/other-jobs-matching/location-only

Nursing at http://mdanderson.referrals.selectminds.com/landingpages/nursing-opportunities-at-md-anderson-cancer-center-7

Houston Area Locations 601100

Requisition #: 114457

MD Anderson provides medical oncology, radiation oncology and surgical oncology services along with a range of supportive programs at all of its Greater Houston area locations. While MD Anderson - The Woodlands treats all types of cancers, the faculty has particular expertise in the diagnosis, treatment and management of the following cancers: Breast; Colorectal; Dermatology and skin; Endocrine; Genitourinary; Gynecologic; Head and neck; Neurologic; Thoracic.

SUMMARY

The Primary responsibilities of the Patient Access Coordinator is to facilitate patient medical and financial clearance using oncology nursing knowledge, clinical judgment, and communication skills to assist in resolving difficulties surrounding patient access and authorization of services. These duties will include management of Patient Access Specialists and Patient Services Coordinators in two Regional Care Centers in close cooperation with the Patient Access Supervisor.

Ideal candidate will have two or more years’ experience in utilization review with external payors within a hospital or insurance setting.

SALARY RANGE

Minimum - $66,800 Midpoint - $83,500 Maximum - $100,200

KEY FUNCTIONS

Patient access

Consistently and accurately utilizes medical acceptance criteria to screen and schedule appointments for new patients in a way to ensure optimal efficiency in clinic operations. Provides financial counseling options to patients including cost estimates, payment plans, discounts, and supplemental financial assistance; utilizing medical overrides and account reviews as appropriate.

Personnel management

Make decisions regarding the hiring process in collaboration with the leadership team and staff. Manage daily staffing coverage to ensure adequate resource coverage for operations

Revenue integrity

Collects complete and accurate financial data during intake process to ensure appropriate financial screening of new patients and verifies data during new patient registration to ensure compliance with required forms and consents. Uses technical expertise to obtain insurance information, verify benefits, and secure authorizations.

Clinical reviews

Performs clinical review of new patient referrals to determine medical acceptance and communicates with patients, referring professionals and MDACC physicians regarding patients who fail to meet medical criteria for acceptance. Uses clinical knowledge to assist with obtaining medical overrides, developing cost estimates, gaining authorization for services, and coordinating pre-determination processes.

Oral and written communication

Uses excellent oral communication and listening skills to communicate with patient, referral source, MDACC physician and MDACC clinical staff regarding obstacles to access or financial clearance. Responds to voicemail and myMDAnderson messages within one business day and answers phone calls in a timely manner (within 3 rings). Completely and accurately documents communications with payors, patients, and the treatment team.

EDUCATION

Required: Graduation from an accredited school of nursing

Preferred: Bachelor of Science in Nursing (BSN)

LICENSE/CERTIFICATION

Required: Current State of Texas Professional Nursing License (RN)

Preferred: Case Management Certification or Certified Healthcare Access Manager

EXPERIENCE

Required: Two years’ experience in nursing or one year related nursing experience in utilization review/insurance/case management/medical clearance.

Preferred: Two years’ experience in utilization review with external payors within a hospital or insurance setting.

It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html