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RN-Utilization Review

Company: Ascension
Location: Milwaukee
Posted on: January 15, 2022

Job Description:

We Are Hiring:Title: RN - Utilization ReviewCity, State: Milwaukee, WILocation: Ascension Columbia St. Mary's HospitalDepartment: Case ManagementAdditional Job Details: .6 FTE / Days730-4 typical hours
We do work weekends and holidays on a rotation.
This role is an every other weekend rotation.
How will Ascension benefit you?

  • Strength in our People: At Ascension, we believe our people are our strength and we invest in them. In addition to the chance to have a positive impact on the people and communities we serve, associates benefit from significant professional opportunities, career advancement, training and competitive wages. We also support work-life balance and spirituality in the workplace.
    • Compensation/Benefits: At Ascension, we care for the people who are the foundation of our work to fulfill our mission: our associates. We offer a comprehensive benefit package inclusive of medical, dental, vision, retirement, and generous PTO. Associates can also take advantage of other great benefits like tuition reimbursement or adoption assistance.
      • Leadership Development: We know that the development of our associates is key to our mission of providing the best care possible to those we serve. We have various in-depth leadership programs to meet you where you are on your career journey.

      • Culture of Teamwork: We encourage diversity of talent and thought; while offering the support of a multidisciplinary team. We work to build teams that respect each other. A team that respects each other feels good. We are on a mission to help people feel good, patients and associates.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 Wisconsin Board of Nursing obtained prior to hire date or job transfer date required. Licensure from the Wisconsin Board of Nursing OR current home state license if considered multi-state/Compact State.Education:
            • Diploma from an accredited school/college of nursing required.Additional Preferences:Acute Care experience 3-5 years
              Insurance background preferred
              MCG/ Interqual experience preferredWhy Join Our Team:For over 170 years, Ascension Wisconsin has been providing rewarding career opportunities at 20 hospital campuses and more than 100 related healthcare facilities from Racine to Eagle River. Nearly 20,000 Ascension Wisconsin associates currently serve in four locations throughout Wisconsin - Wheaton Franciscan Healthcare, Ministry Healthcare, Columbia St. Mary's, and Affinity Healthcare. We provide generous paid time off for work-life balance, a collaborative work environment, professional development opportunities, and more to help our associates flourish personally and professionally. If you are looking for a rewarding career in healthcare, we invite you to apply today.

              When you join Ascension, 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. In fact, Ascension spent nearly $46 million in tuition assistance alone to support associate growth and development. 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 Wisconsin is an equal opportunity employer (EEO) and affords equal opportunity to all associates and applicants without regard to race, color, religion, national origin, citizenship, gender identity, sexual orientation, age, physical or mental disability, veteran status, genetic data, or other legally protected status.

              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.

Keywords: Ascension, Milwaukee , RN-Utilization Review, Healthcare , Milwaukee, Wisconsin

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