RN Clinical Utilization Manager

4 weeks ago


New York, New York, United States Ascension Full time
Job Summary

We are seeking a skilled Registered Nurse to join our Utilization Management team as a Clinical Utilization Manager. In this role, you will be responsible for reviewing admissions and service requests to ensure medical necessity and compliance with reimbursement policy criteria.

As a Clinical Utilization Manager, you will work closely with the healthcare team to provide case management and consultation for complex cases. You will also assist with issues related to coding, medical records/documentation, precertification, reimbursement, and claim denials/appeals.

Requirements:

  • Licensed Registered Nurse credentialed from the Kansas Board of Nursing required
  • Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire

About Ascension

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.

We are committed to providing high-quality, patient-centered care to our communities. Our associates are empowered to give back, volunteer, and make a positive impact in their community.

Equal Employment Opportunity Employer



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