Surgical Eligibility Nurse

About the role

Integra Vascular provides patient-focused, preventative vascular care to residents of our communities and long-term care facilities. Our mission is to minimize unnecessary wounds, hospitalizations, and patient travel through early diagnosis, appropriate clinical review, and exceptional onsite treatment. Guided by our commitment to clinical excellence, we deliver advanced vascular care that improves function, comfort, and quality of life for every patient we serve.

Key Responsibilities

• Review referred surgical patients across NY, NJ, and FL to assess eligibility for PAD, SVI, and embolization-related procedures in accordance with physician direction, internal criteria, and applicable documentation standards.
• Evaluate patient records, diagnostic imaging, vascular studies, provider notes, medical history, medication lists, allergies, labs, and other relevant clinical information to determine whether the patient is appropriate to advance in the surgical workflow.
• Confirm that required clinical documentation and diagnostics are complete, accurate, and current prior to scheduling or final physician review.
• Identify missing information, contraindications, clinical concerns, or risk factors that may delay or prevent procedural scheduling and communicate those items clearly to the appropriate internal team or provider.
• Collaborate with the Director of Surgical Care Coordination to maintain a consistent multi-state eligibility review process for all surgical patients and procedure categories.
• Partner with Surgical Scheduling Coordinators to ensure only appropriately reviewed and eligible patients are moved forward for procedure scheduling.
• Maintain and update master patient tracking lists, ensuring each patient’s status, eligibility determination, pending items, documentation gaps, and next steps are accurately reflected.
• Serve as a clinical resource to scheduling and operational staff regarding patient eligibility, prioritization, required documentation, and procedural readiness.
• Escalate complex or questionable cases to the appropriate physician, provider, or Director of Surgical Care Coordination for further review before scheduling decisions are finalized.
• Coordinate with authorization, OBL site teams, field clinical teams, and administrative staff to help resolve barriers that prevent eligible patients from reaching procedural readiness.
• Support medical necessity review by ensuring that clinical documentation supports the referred procedure and aligns with internal standards and payer-related requirements, as applicable.
• Monitor patients who require additional workup and assist in preventing eligible or potentially eligible patients from remaining idle in the surgical pipeline.
• Provide clear and timely communication to internal stakeholders regarding eligibility decisions, documentation needs, and case status updates.
• Track and report eligibility trends, denial reasons, documentation gaps, procedural approval patterns, patient readiness issues, and other workflow metrics to identify opportunities for improvement.
• Participate in surgical coordination meetings and provide clinical feedback on patient volume, eligibility concerns, scheduling readiness, and process enhancements.
• Maintain confidentiality and handle all patient information in accordance with HIPAA, state and federal healthcare requirements, and Integra Vascular’s internal compliance standards.

Qualifications

• Active Registered Nurse license required; licensure in applicable operating state(s), or ability to obtain and maintain appropriate licensure for NY, NJ, and/or FL workflows, preferred or as required by business need.
• Minimum of 2 years of clinical nursing experience required; experience in vascular care, interventional radiology, perioperative nursing, OBL/ASC settings, cardiology, wound care, or long-term care preferred.
• Working knowledge of PAD, SVI, embolization-related procedures, vascular anatomy, patient risk factors, and common pre-procedural considerations preferred.
• Strong ability to review clinical documentation and identify missing, inconsistent, or clinically relevant information affecting procedural eligibility.
• Excellent organizational skills with the ability to manage multiple patient lists, deadlines, and procedure categories across multiple states.
• Strong written and verbal communication skills with the ability to collaborate effectively with physicians, providers, nurses, schedulers, authorization staff, OBL teams, and field clinical teams.
• Proficiency with EMR systems, Microsoft Office, patient tracking tools, and related workflow platforms.
• High attention to detail, sound clinical judgment, and ability to escalate concerns appropriately.
• Ability to work independently while maintaining alignment with clinical leadership and surgical coordination standards.

Core Competencies

• Clinical judgment and patient safety focus
• Multi-state workflow coordination
• Documentation accuracy and compliance awareness
• Strong follow-through and patient tracking discipline
• Clear communication and cross-department collaboration
• Process improvement mindset
• Professional discretion and confidentiality

Benefits

• Comprehensive Health Insurance, including Medical, Dental, and Vision
• Flexible Spending Account and Dependent Care Account options
• 401(k) Retirement Plan with company match
• Paid Time Off and company-recognized holidays
• Professional development and continuing education support
• Collaborative and growth-oriented clinical environment