Ascension Health is the largest nonprofit organization that specializes in providing Catholic faith-based, comprehensive healthcare services in the United State
Registered Nurse Utilization Review
Location
United States
Posted
7 days ago
Salary
0
Seniority
Senior
Job Description
Registered Nurse Utilization Review
Ascension Health
Title: RN Utilization Review Job Description: Location: Remote USA Nursing Job ID: 449870 Facility: Ascension Network Services Department: Utilization Management Schedule: Full Time l Day Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 99,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter. Benefits that help you thrive - Comprehensive health coverage:medical, dental, vision, prescription coverage and HSA/FSA options - Financial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance - Time to recharge: pro-rated paid time off (PTO) and holidays - Career growth: Ascension-paid tuition (Vocare), reimbursement, ongoing professional development and online learning - Emotional well-being: Employee Assistance Program, counseling and peer support, spiritual care and stress management resources - Family support:parental leave, adoption assistance and family benefits - Other benefits: optional legal and pet insurance, transportation savings and more Benefit options and eligibility vary by position, scheduled hours and location. Benefits are subject to change at any time. Your recruiter will provide the most up-to-date details during the hiring process. How you’ll make an impact in this role - Provide healthcare services related to admissions, case management, discharge planning, and utilization review. - Review admissions and service requests for medical necessity, reimbursement compliance, and utilization management criteria. - Support complex case management and assist staff with coding, documentation, precertification, reimbursement, and denial/appeal issues. - Coordinate discharge planning needs with patients, providers, and interdisciplinary healthcare teams. - Ensure compliance with federal regulations and third-party payer utilization management requirements while preparing reports and statistical analyses as needed. What minimum requirements you’ll need Licensure / Certification / Registration: - Licensed Registered Nurse credentialed from the Texas Board of Nursing or current home state license for multi-state license recognition "Compact State" obtained prior to hire date or job transfer date required. Education: - Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire. Equal employment opportunity employer Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster. Fraud prevention notice Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system. E-Verify statement Employer does not participate in E-Verify and therefore cannot employ STEM OPT candidates.
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