RN Utilization Review Analyst

3 weeks ago

Detroit, Michigan, United States Ascension Health Full time

Details

  • Department: Case Management
  • Schedule: PRN
  • Hospital: St John Main
  • Location: Detroit, MI

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

*Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: Travel, PRN, Short-Term Option, etc.). Actual compensation offer will vary based upon role, education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics.

Responsibilities

Analyze and evaluate concurrent admission information and assigned patient population for supporting admissions and discharge planning.

  • Assess clinical documentation based on current recognized criteria.
  • Contact third party payers to communicate clinical information/complete pre-certification and re-certification parameters.
  • Coordinate with team members to obtain information that supports sustaining admission or preparing discharge plans.
  • Collate/analyze indicator data to support outcomes and report to medical staff committee.

Requirements

Licensure / Certification / Registration:

  • Practical/Vocational Nurse credentialed from the Michigan Board of Nursing preferred.
  • Registered Nurse credentialed from the Michigan Board of Nursing preferred.
  • BLS Provider credentialed from the American Heart Association (AHA) preferred.
  • Reg Health Info Tech credentialed from the American Health Information Management Association (AHIMA) preferred.

Education:

  • High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.

Additional Preferences

Experience:

  • Prior experience preferred
  • Prior hospital experience preferred
  • Hospital insurance knowledge highly recommended

Why Join Our Team

Ascension Michigan operates 16 hospitals and more than 300 related healthcare facilities that together employ nearly 23,000 compassionate associates. When you join our care teams, you join a team dedicated to providing spiritually centered, holistic care which sustains and improves the health of the communities we serve throughout Michigan.

Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.

Equal Employment Opportunity Employer

Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran 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.

As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

Pay Non-Discrimination Notice )

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

E-Verify Statement

This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.

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