Registered Nurse Utilization Management

Ascension • Wichita, KS

21h • $40 - $57 • Remote

About The Position

This role involves leading the review of admissions and service requests to ensure patient journeys align with medical necessity and reimbursement standards. The nurse will act as a consultant for departmental teams, navigating coding, documentation, and precertification to resolve claim denials and manage appeals. They will also oversee adherence to federal regulations and third-party payer rules, and prepare statistical analyses and utilization reports.

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.

Nice To Haves

• Demonstrated experience in Utilization Management (UM) or Case Management.

Responsibilities

• Lead the charge in reviewing admissions and service requests to ensure every patient’s journey aligns with medical necessity and reimbursement standards.
• Act as a go-to consultant for our departmental teams, navigating the complexities of coding, documentation, and precertification to resolve claim denials and manage the appeals process seamlessly.
• Serve as a guardian of quality, overseeing and coordinating our adherence to federally mandated regulations and third-party payer rules.
• Step in to prepare statistical analyses and utilization reports that help shape our future strategies.

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 to give back to your community
• Tuition discounts
• Priority placement in select healthcare programs through our academic partnership with Wichita State University.

What This Job Offers

• Career Level: Mid Level
• Education Level: Associate degree