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Ascension logo
Ascension

The Leader in Faith Formation

Registered Nurse Utilization Review

Location

United States

Posted

19 days ago

Salary

$84.1K - $118.7K / year

Seniority

Mid Level

No structured requirement data.

Job Description

Registered Nurse Utilization Review

Ascension

Role Description Your future role at a glance: - Location: Remote - Facility: Ascension Network Services - Department: Utilization Management - Schedule: Days | Full Time - Salary range: $84,060.91 - $118,668.99 per year (Texas) | Pay ranges vary based on candidate geographic location How you’ll make an impact in this role: - Provide health care services regarding admissions, case management, discharge planning and utilization review. - Review admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. - Provide case management and/or consultation for complex cases. - Assist departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals. - Assess and coordinate discharge planning needs with healthcare team members. - May prepare statistical analysis and utilization review reports as necessary. - Oversee and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. Qualifications - 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. Benefits - 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. Company Description 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.

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