Registered Nurse Utilization Management

 Posted 3 hours ago
     
 $40.41 - $57.05 per hour
  
2-5 years experience
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AI Summary

Review admissions and service requests to ensure alignment with medical necessity and reimbursement standards. Act as a consultant for coding and documentation to resolve claim denials and manage the appeals process.

We Are Hiring

Location: Remote - Preference to reside in Greater Wichita, KS Area 

Facility: Via Christi Hospitals 

Department: Utilization Management  

Schedule: Day  l  PRN  

Salary Range: $40.41 - $57.05/hour 

 

Via Christi associates are eligible for tuition discounts and priority placement in select healthcare programs through our academic partnership with Wichita State University.

What You Will Do

  • 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.

What You Will Need

Licensure / Certification / Registration:

  • Licensed Registered Nurse credentialed from the Kansas Board of Nursing required.

Education:

  • Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire.

Additional Preferences

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

Why Join Our Team

Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 97,000+ 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.

Equal Employment Opportunity Employer

Equal employment opportunity employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

Fraud prevention notice

Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system.

E-Verify statement

Employer participates in the Electronic Employment Verification Program. Please click here for more information.

 

Benefits

Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits including employer match plansLong-term & short-term disabilityEmployee assistance programs (EAP)Parental leave & adoption assistanceTuition reimbursementWays to give back to your community

 

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.

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