RN Healthcare Specialist

4 weeks ago


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

Ascension Via Christi is seeking a skilled RN to join our team as a Healthcare Specialist. In this role, you will provide health care services regarding admissions, case management, discharge planning, and utilization review. Your expertise will be utilized to review admissions and service requests within assigned units for prospective, concurrent, and retrospective medical necessity and/or compliance with reimbursement policy criteria.

Responsibilities

Provide health care services regarding admissions, case management, discharge planning, and utilization review.
Review admissions and service requests within assigned units 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.

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 Via Christi caregivers have been caring for and providing healing to Kansas communities for more than 135 years. As the largest healthcare provider in Kansas, we offer career opportunities across a number of hospitals, clinics, therapy centers, and home health services. 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 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 an equal employment opportunity employer and welcome applications from diverse candidates.

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