Registered Nurse – Utilization Review

🔥 15 hours ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $84.1k - $118.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Ascension

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Ascension is a faith-based healthcare organization dedicated to transformation through innovation across the continuum of care. As one of the leading non-profit and Catholic health systems in the U. S. , Ascension is committed to delivering compassionate, personalized care to all, particularly focusing on those living in poverty and the most vulnerable populations. Operating over 2,600 sites of care, including 151 hospitals, Ascension offers a variety of services, including physician practice management and clinical care management, while emphasizing a mission of community benefit.

📋 Description

• Reviews admissions and service requests for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria • Provides case management and/or consultation for complex cases • Assists departmental staff with coding, medical records/documentation, precertification, reimbursement and claim denials/appeals • Assesses and coordinates discharge planning needs with healthcare team members • May prepare statistical analysis and utilization review reports • Oversees and coordinates compliance with federally mandated and third-party payer utilization management rules and regulations

🎯 Requirements

• Registered Nurse credentialed from the Texas Board of Nursing obtained prior to hire date or job transfer date • Diploma from an accredited school/college of nursing required OR required professional licensure at time of hire

🏖️ Benefits

• Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options • Employer-matched 403(b) • Planning and hardship resources • Disability and life insurance • Pro-rated paid time off (PTO) and holidays • Ascension-paid tuition (Vocare) • Tuition reimbursement • Ongoing professional development and online learning • Employee Assistance Program • Counseling and peer support • Spiritual care and stress management resources • Parental leave • Adoption assistance and family benefits • Optional legal and pet insurance • Transportation savings

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