Utilization Review RN
2 weeks ago
- Department: Utilization Review
- Schedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays required
- Facility: Ascension Care Management Insurance
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.
ResponsibilitiesAs the Utilization Review RN, you'll 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 health-care 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.
Licensure / Certification / Registration:
- Registered Nurse obtained prior to hire date or job transfer date required. Licensure required relevant to state in which work is performed.
Education:
- Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire.
Additional Preferences:
- RN Compact License, required
- Bachelors in Nursing, preferred
- 3 years of clinical experience, preferred
- 2-3 years of utilization managment and managed care experience, preferred
#LI-Remote
Why Join Our TeamAscension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters.
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 EmployerAscension 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.
E-Verify
-
Utilization Review RN
5 days ago
Austin, TX, United States Ascension Seton Northwest Full timeUtilization Review RN Details * Department: Utilization Review * Schedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays required * Facility: Ascension Care Management Insurance Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including...
-
RN Mgr-Utilization Review
5 days ago
Austin, TX, United States Ascension Seton Northwest Full timeRN Mgr-Utilization Review Details * Department: Utilization Management * Schedule: FT - Days * Location: Remote after training 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...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
RN-Utilization Review
1 month ago
Austin, TX, United States Ascension Seton Northwest Full timeRN-Utilization ReviewDetails * Department: UR Review * Schedule: FT - Days * Location: Austin, TX - Remote after 4 weeks of training onsite 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...
-
Utilization Review RN
2 weeks ago
Austin, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
Utilization Review RN
2 weeks ago
Austin, TX, United States Ascension Full timeDetails Department: Utilization Review Schedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays required Facility: Ascension Care Management Insurance Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans ...
-
RN-Utilization Review
4 weeks ago
Austin, United States Ascension Full timeDetails Department: UR ReviewSchedule: FT - DaysLocation: Austin, TX - Remote after 4 weeks of training onsiteBenefits 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...
-
RN Manager
5 days ago
Austin, Texas, United States Ascension Seton Northwest Full timeJob SummaryWe are seeking a highly skilled and experienced RN Manager to lead our Utilization Review and Optimization team at Ascension Seton Northwest. As a key member of our clinical leadership team, you will be responsible for managing effective utilization review processes, collaborating with directors to develop quality review programs, and overseeing...
-
RN Mgr
5 days ago
Austin, Texas, United States Ascension Seton Northwest Full timeJob SummaryWe are seeking a skilled RN Utilization Review Manager to join our team at Ascension Seton Northwest. The successful candidate will be responsible for managing effective utilization review processes, including patient statusing and medical necessity review functions.Key ResponsibilitiesCollaborate with the director to develop and implement quality...
-
Clinical Utilization Review Nurse
7 days ago
Austin, Texas, United States Ascension Seton Northwest Full timeJob SummaryWe are seeking a skilled Clinical Utilization Review Nurse to join our team at Ascension Seton Northwest. As a Utilization Review Registered Nurse, you will play a critical role in ensuring the quality and efficiency of our healthcare services.Key ResponsibilitiesConduct thorough reviews of patient admissions and service requests to determine...
-
Clinical Utilization Review Specialist
2 days ago
Austin, Texas, United States Ascension Seton Northwest Full timeJob Summary:The Clinical Utilization Review Specialist will provide healthcare services regarding admissions, case management, discharge planning, and utilization review. This role requires a strong understanding of medical necessity and reimbursement policy criteria.Responsibilities:Review admissions and service requests within assigned units for...
-
Utilization Review RN
2 weeks ago
Austin, TX, United States Ascension Full timeDetails Department: Utilization ReviewSchedule: Full-time, 8-hour day shift, Monday-Friday, Remote, including occasional on-site needs, weekends and holidays requiredFacility: Ascension Care Management InsuranceBenefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term &...
-
RN Mgr-Utilization Review
1 week ago
Austin, United States Ascension Full timeDetails Department: Utilization ManagementSchedule: FT - DaysLocation: Remote after training 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...
-
RN Mgr-Utilization Review
1 week ago
Austin, United States Ascension Full timeDetails Department: Utilization ManagementSchedule: FT - DaysLocation: Remote after training 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...
-
RN Mgr-Utilization Review
1 week ago
Austin, United States Ascension Full timeDetails Department: Utilization ManagementSchedule: FT - DaysLocation: Remote after training 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...
-
RN Mgr-Utilization Review
1 week ago
Austin, United States Ascension Full timeDetails Department: Utilization ManagementSchedule: FT - DaysLocation: Remote after training 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...
-
Healthcare Utilization Review Specialist
7 days ago
Austin, Texas, United States UHS Full timeJob SummaryThe Utilization Review Coordinator PRN is a key member of the Austin Oaks Hospital Team who is responsible for ensuring that financial benefits are maximized in the treatment and discharge planning for assigned cases through initial and continued stay reviews, prior authorization work for discharge services, effective liaison work and...