RN - Utilization Review Remote Full Time

We Are Hiring Title: RN Utilization Review Department: Quality Management Schedule: Full-Time, Days 8am-4:30pm Mon-Fri some weekends/holidays may be required Location: Remote What You Will Do Provide health care services regarding admissions, case management, discharge planning, and utilization review. 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. What You Will Need Licensure / Certification / Registration: Registered Nurse credentialed from the Illinois Board of Nursing obtained prior to hire date or job transfer date. Education: Diploma from an accredited school/college of nursing required. Additional Preferences Previous Utilization Management experience preferred. E.M.R.s: Epic, Cerner, Meditech and Midas. Google Suite, Microsoft Office Why Join Our Team Ascension Illinois, one of the largest health systems in Illinois, with 15 hospitals and over 150 sites of care, serves over 6.6 million residents in the greater Chicagoland area. A career at Ascension means you join a team of over 150,000 individuals across the country committed to a Mission of serving others and providing compassionate, personalized care to all. Our inclusive culture, continuing education programs, career coaches and benefit offerings are just a few of the resources and tools that team members can use to create a rewarding career path. If you are looking for a career where you can grow and make a difference in your community, we invite you to join our team today. Equal Employment Opportunity Employer Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws. For further information regarding your EEO rights, click on the following link to the “EEO is the Law” poster: http://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf EEO is the Law Poster Supplement Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants. This employer participates in the Electornic Employment Verification Program. Please click the E-Verify link below for more inforamtion. E-Verify