Registered Nurse Utilization Review

Your future role at a glance

Location: Remote

Facility: Ascension Network Services

Department: Utilization Management

Schedule: Days l Full Time

Salary range: $84,060.91 - $118,668.99 per year (Texas) | Pay ranges vary based on candidate geographic location

How you'll make an impact in this role

• Managed admissions, case management, discharge planning, and utilization review to support quality patient care and efficient care coordination.
• Reviewed admissions and service requests for medical necessity, reimbursement compliance, and utilization management, while providing case management support for complex cases.
• Collaborated with clinical and administrative teams to resolve issues related to coding, medical documentation, precertification, reimbursement, and claim denials or appeals.
• Coordinated discharge planning with interdisciplinary healthcare teams to ensure appropriate transitions of care and continuity of services.
• Monitored compliance with federal regulations and third-party payer utilization management requirements, while preparing utilization review reports and performance metrics as needed.

What minimum qualifications you'll need

Licensure / Certification / Registration:

• 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.

Education:

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

Life at Ascension: Where purpose meets opportunity

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 does not participate in E-Verify and therefore cannot employ STEM OPT candidates.

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.