Registered Nurse – Utilization Review

Job not on LinkedIn

🔥 32 minutes ago

🌴 South Carolina – Remote

🌴 South Carolina – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Tenet Healthcare

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

👥 B2C

💰 $2G Post IPO debt on 2022-07

Healthcare • B2C

Tenet Healthcare is a for-profit healthcare services company that owns and/or operates hospitals and hospital programs through subsidiaries and affiliates across the United States. The company's website and materials describe acute-care hospitals, emergency centers, specialty services (including cancer centers and advanced cardiac imaging), medical office buildings, physician careers and community health networks; Tenet emphasizes compliance, community service, and clinical innovation.

📋 Description

• Coordinate clinical care and resource utilization by evaluating medical necessity, appropriateness of care, continued stay, and discharge planning • Complete and submit admission and concurrent reviews to payers • Secure authorizations and identify/document avoidable days • Communicate and document clinical information to payers regarding admissions, level of care, length of stay, and authorization requirements • Advocate with payers to obtain appropriate reimbursement, prevent denials, and manage dispute resolution, including secondary reviews and peer-to-peer appeals • Educate and guide physicians and healthcare teams regarding care progression, appropriate level of care, safe patient transitions, and available resources and benefits • Ensure compliance with federal, state, and local regulations and accreditation requirements

🎯 Requirements

• Associates in Nursing required • At least two years acute hospital or Behavioral Health patient care experience • Active Registered Nurse license required • BSN preferred • Accredited Case Manager (ACM) preferred

🏖️ Benefits

• Medical, dental, vision, and life insurance • 401(k) retirement savings plan with employer match • Generous paid time off • Career development and continuing education opportunities • Health savings accounts • Healthcare and dependent flexible spending accounts • Pet insurance • Legal insurance • Accident and critical illness insurance • Long-term care • Elder and childcare benefits • Auto and home insurance • Up to $20,000 sign-on bonus based on eligibility