RN Utilization Review

Ascension • Austin, TX

1d • $84,061 - $118,669 • Remote

About The Position

Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 99,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter.

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

• Provide healthcare services related to admissions, case management, discharge planning, and utilization review.
• Review admissions and service requests for medical necessity, reimbursement compliance, and utilization management criteria.
• Support complex case management and assist staff with coding, documentation, precertification, reimbursement, and denial/appeal issues.
• Coordinate discharge planning needs with patients, providers, and interdisciplinary healthcare teams.
• Ensure compliance with federal regulations and third-party payer utilization management requirements while preparing reports and statistical analyses as needed.

Benefits

• Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options
• Financial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance
• Time to recharge: pro-rated paid time off (PTO) and holidays
• Career growth: Ascension-paid tuition (Vocare), reimbursement, ongoing professional development and online learning
• Emotional well-being: Employee Assistance Program, counseling and peer support, spiritual care and stress management resources
• Family support: parental leave, adoption assistance and family benefits
• Other benefits: optional legal and pet insurance, transportation savings and more

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree