RN-Utilization Review
Ascension•Austin, TX
•$84,061 - $118,669•Remote
About The Position
This role is for a Registered Nurse specializing in Utilization Review within the Ascension Network Services, specifically in the Utilization Management department. The position is remote and part-time, with working hours during the day. The salary range is $84,060.91 - $118,668.99 per year, with variations based on geographic location.
Requirements
- Licensed Registered Nurse credentialed from the Texas Board of Nursing or current home state license for multi-state license recognition "Compact State" obtained prior to hire date or job transfer date required.
- Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire.
Responsibilities
- Review admissions and service requests within assigned unit 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.
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
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What This Job Offers
Job Type
Part-time
Career Level
Mid Level
Education Level
Associate degree
