[Hiring] Registered Nurse - Utilization Review @Ascension

Role Description

Your future role at a glance:

• Location: Jacksonville, FL | Remote
• Facility: Ascension St. Vincent's Riverside Hospital
• Schedule: Day Shift | PRN
• Salary Range: $47.00 - $50.00 per hour

How you’ll make an impact in this role:

• Lead the end-to-end medical necessity review process, ensuring admissions and service requests meet all reimbursement and compliance criteria.
• Provide expert case management and consultation for high-complexity cases to optimize patient outcomes.
• Resolve departmental hurdles related to coding, documentation, and precertification while navigating the claims and appeals process.
• Strategize with the healthcare team to assess and execute seamless discharge plans tailored to patient needs.
• Spearhead compliance with federal and third-party payer regulations, leveraging data and utilization reports to drive operational excellence.

Qualifications

• Licensure / Certification / Registration: Licensed Registered Nurse obtained prior to hire date or job transfer date. Licensed as a Registered Nurse in Florida. Credentialed from State 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 required.

Benefits

• Retirement: 403(b) plan
• Well-being support: Employee Assistance Program, counseling and peer support, spiritual care and stress management resources

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.