[Hiring] RN Utilization Review @Ascension

Role Description

Your future role at a glance:

• Location: Remote
• Facility: Ascension Network Services
• Department: Utilization Management
• Schedule: Days | Part 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:

• 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

• Paid time off (PTO)
• Various health insurance options & wellness plans
• Retirement benefits including employer match plans
• Long-term & short-term disability
• Employee assistance programs (EAP)
• Parental leave & adoption assistance
• Tuition reimbursement
• Ways to give back to your community

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.