registered nurse

registered nurse - medical / surgical

medical assistant

licensed vocational nurse

pharmacy technician

University Health

Unfortunately the organization’s leadership structure has changed and the organization shifted from being employee-centered to being profit-centered at the expense of the employees. Nursing units are always short staffed and unequally budgeted depending on how the organization values your department and leadership in that department. The benefits are still very competitive with other health systems and that should be factored into the lower than industry hourly rate for hourly staff. One good thing is that there is a minimum wage for lower paid staff that far exceeds the federal minimum wage.  If salaried though, the job requirements keep changing with added responsibilities that are not in the job description and nothing is removed to allow for the additional time required to be successful. As a result, work life balance for managers and above diminishes every year. Also there are so many almost daily changes from the top-heavy leadership that the lower management and staff have change fatigue. Attrition rates are high and not only because of Covid which struck at the same time the organization changed its electronic health record system which was literally pushed out with minimal on-line only training. Many nurses left to take agency work for triple pay. It’s time to pare down the senior leadership and beef up the mid-level managers and front-line workers to do the good work they came to do. There is little standardization between clinical areas which is not conveyed to similar departments that would benefit from “lessons already learned”. Everyone is doing something different and the system is working against itself. Budgets are pared down every year, do more with less, but at some point it affects quality and morale. There is no system for employees to make suggestions which there should be. Who better to point out the deficiencies than those at the front line?  Many years ago when the senior leadership changed due to many retirements and a job-elimination campaign, a daily morning leadership huddle was implemented to mirror the Toyota model. It was a move in the right direction—a “just culture” where leadership shared and learned from their mistakes and were not punished for them. The President/CEO used to attend them,  then stopped coming after about six months and we never saw him again. That huddle quickly devolved into a statistical daily report-only meeting that basically wasted a half hour of valuable leadership time. If a manager pointed out a error or mistake in the huddle, they were sure to get a dressing down from the leader above them later that day. It’s top-down leadership now and it should be transformational to work the way they want—to support the organization’s mission. The pension plan was no longer offered since 2012 which really kept good employees from jumping to another health organization. Now the staffing is a revolving door. Sadly there is no mechanism in place to let the hospital President/CEO know what is really going on. It’s all smoke and mirrors now. If you are just there to work, clock in and out when you are supposed to, keep your head down and don’t complain, you will be fine.  Unfortunately that mentality breeds mediocrity and apathy. 

A typical day at work consisted of cataloguing and processing Grievances and Appeals submitted by medical Providers for additional payment or to overturn denials. An independent code review program was used to review our system's payment or denial of CPT codes and diagnoses codes. If the code review process could not be resolved at my level, it was documented and forwarded to the next levels; which included a Registered Nurse, a Medical Director, and an independent Entity if necessary. I documented the outcome, updated our management systems,adjudicated the claim, if necessary and updated the Provider on the decision within a 30 day turnaround from the date of receipt.

The position was new to our organization when I applied. I had eight years previous managed health care experience and I was the only applicant. I used my previous knowledge to develop and navigate the mechanics of the position, as there was very little training available other than the theory of the desired outcome. I learned a lot about Quality Improvement and the Grievance and Appeals process internally and externally; coding and billing processes; mistakes made by billing companies and provider's staff that caused denials or deminished payment levels, and claims adjudication.

Management trusted my knowledge and skill to handle the work independently.

My coworkers and I were were a very close-knit team. A lot of our experiences overlapped and that allowed us to discover trends to report to other departments for the best outcome to our members and providers.

The hardest part of the job was the large volume of Appeals submitted for review.

The most enjoyable part of the job were my co-workers. Our jobs were inherently stressful due to the nature of our positions and we relied on each other for relief.

I was initially very excited to work for UHS. The benefits and culture seemed amazing. But I learned quickly that much of it was hype and propaganda, at least for non-clinical staff. There are very clear tiers of importance attached to different departments. Basically, if your dept/team doesn't make the org a ton of money, you don't get nearly the same treatment as depts. that do. The one I worked in had enormous volumes of work that increased month over month the entire time I was there, yet every request to get additional employees or resources was denied by management; meanwhile our sister dept. that made tons more money than us, got whatever they wanted. It could be hyperbole, but without communication from mgmt. it's all about optics.
Over time, the massive delays from HR getting organizational-wide raises to everyone - took 6 months for me and two others to get ours, months to get reimbursed for tuition costs, the lack of resources to allow people to promote to more advanced positions, the denial of a raise after getting a more advanced certification, to finally, a change in policy that effectively cancelled WFH status to the entire dept. is what broke me.
It may be different with clinical staff but as non-clinical, beware of the promises they give. They have no problem rescinding them and completely rewriting what made you want to work there in the first place.

They tell you it’s a teaching company and gaslight you into benefits and how well staff will open door for improvement when needed and do the opposite. If you ask for clarification on something you did not grasp trainers(preceptors) make you feel like you’re indeed asking a dumb question, with attitude not to mention how impatient they are while teaching. That eventually becomes stressful from my experience here. Management emphasizes on files such as artificial nails and yet there are nurses and medical assistants with acrylics and chipped polishes putting hands on patients. They will write you up from wearing a different colored sweater than solid black non logo stamped when you first board on. But there’s employees with Nike logos and more roaming the halls but receive otherwise treatment because they’ve been there longer. Medical assistants shouting out inappropriate words in the presence of patients young or elderly. The attitudes that I endured while working here has progressed among the staff to the point of which it’s sad to say we have “Team Huddles”. Onboarding everyone was so helpful but as soon as you hit your mark you’re trash in their eyes. The VALUES university claims are out the window once you disagree with someone. Safety for employees is a disaster when it comes to management decisions. 

My experience while being there was good. I loved my coworkers. I gained lifetime friendships with my medical assistant girls that worked beside me and helped me to get through my hard times when i first arrived to the clinic with no experience. I thank them so much for showing me what i didnt know. I got along with everyone. On a busy day it was hectic but handled professionally and thats when teamwork was enabled. The hardest part of my job was dealing with a difficult patient that wouldnt get what they wanted from us and had to end up calling security to escort them out. On occasion i would have to stay after hours to catch up, get home late and sleep for a couple of hours and up again for another day of work. There was no complaints because i liked my job and what i would do. I learned that as long as you work together as a team you can get things done in a professional manner and having patience is a key to working in an urgent care clinic because it does become overwhelming at times. I was able to get some experience i didnt have while being there and want to be able to get an opportunity to use what i learned while being there elsewhere.

At first I loved working at UHS until I got off orientation and realized we are ALWAYS understaffed!!  Management always want nurses to pick up shift, but do not offer any incentives. If we have enough RNs, then we are usually short techs, and have to do total care for our 4-5 pts. May not sound too bad, but working on a surgical trauma floor, most of your patients need assistance getting up to go to the restroom or doing any ADLs,  if they can even get up at all.  Half of our techs our great and the other half are usually sitting around trying to get out of doing any work or hiding.  They are constantly adding more to our workload without increasing pay or helping in any other way.Thank GOD my PCC and other nurses I work with are amazing or I would have left a long time ago. Pay is awful, like a total joke, benefits are decent. There is no room for advancement. If using the insurance provided you have to use docs that are either with UHS or UT making it difficult to get in to their office, especially pediatrics, because they rarely are accepting new patients. You have the option to go out of network but that costs an arm and a leg and totally not worth it. Administration is a joke. Hopefully something changes or they decide they need to be paying their nurses better because I will soon be looking for a new job.

This is a big organization and some departments are better than others.  Unfortunately many departments are overworked and over stressed as is apparent by the attitude that many employees give their patients and colleagues. Many positions, if not most, only give 30 minutes for lunch break.  When you factor in how large the hospital is, the distance you have to walk to get to your car in the garage, it is almost impossible to get out of your car, pick up lunch, and the get back again in that time.  To top it off, the cafeteria offers poor quality food and a negligible discount.  Many employees consistently work through their lunches and breaks are almost nonexistent.  Again, this is a large organization so other departments may have different experiences.  Another negative is that their health insurance package is somewhat limited to providers within the San Antonio area which is not at all convenient should you ever need coverage while traveling.  Their PTO scheme is odd.  There are no designated “Sick” hours and you must also be sure to keep enough hours in your PTO bank to cover any federal holidays or you won’t get paid for them and may get written up for not having enough hours to cover.

I promptly and efficiently performed a variety of projects or assignments which required familiarity with general office operations and complied with the instructions. I performed the following task a skilled level of coding specialist, handled, counted and maintained records of cash, para- administrative and clerical duties that supported clinical services, such as registration, patient reception, scheduling, canceling appointments, patient arrival and dismissal, patient account inquiry, billing & accounts receivable, extreme accuracy and attention to detail, financial screening, managed care, cash collections, referral coordination, registration, answering incoming calls, coordinated actives and work relation, advocate for the patient to providers, Doctor hourly schedules, responsible for two clinics Sports Medicine, Vasectomy in which I worked closely with 2 MD’s. Office equipment knowledge is of the following fax, copier, computer, medical record imager, medi-fax, acd telephone equipment, oversees the daily functions for front office, maintained strict confidently of patient records, and obtained insurance benefits and pre-cerfication if required, knowledge of billing and insurance contracts.

I worked as a Manager of Case Management over social workers and RN Case Managers M-F 8:30-5:00 in a Salary position. I learned how to speak in front of others, lead a group of professionals, submit reports, working with the emergency response team, working with other departments and reporting to the chief financial officer. I then went to the Hospital Nurse Admission role where I assisted with reviewing all admissions for minor and major surgical procedures for the hospital and clinics, observations, inpatient admissions, coding with medical records, Medicaid and Medicare reimbursements retroactively for radiology procedures and help develop a medical program called Sunrise which is in use now. The culture was of a learning hospital at University of the Health Science Center and Veterans Administration. The hardest part of job was not allowing patients to receive care due to poor management of their physician for care or their ability to pay. The most enjoyable part was to get those that needed healthcare and had the ability to pay to expedite 
their care and save the  hospital money to deliver efficient care I reported to the Medical Director.

To start my morning I would arrive 30 min early and receive a verbal report from the CNA and Nurse that cared for the patient during the night. I then go and introduce myself to all the patients that I would be in care of. Help patients with personal care as well as taking vitals assisting nurse with wound care recording intake and output etc. 

As a Unit clerk I would update the bed assignments, order nourishment for the unit, assign, admit patients to the unit under charge nurse orders, discharge patients, keep charts neat and organized, answer unit multi- line phone system, etc. 

I have learned that there is many aspects of helping a person recover and heal form sickness or injury and I had a integral roll in patients recovery. 

My co-workers were great we always worked at a team through good  and bad days.

 The hardest part of the job is the loss of a child's life. 

The most enjoyable is seeing miracles happen. To see a child make a remarkable recovery from illness or injury.

Top Job Titles	Average Salary
Registered nurse 2690 salaries reported	$44.18 per hour
Registered nurse - medical / surgical 596 salaries reported	$21.76 per hour
Medical assistant 484 salaries reported	$21.06 per hour
Licensed vocational nurse 367 salaries reported	$26.43 per hour
Pharmacy technician 301 salaries reported	$23.92 per hour

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