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RN-Utilization Review

Company: Ascension Health
Location: Milwaukee
Posted on: September 24, 2022

Job Description:

We Are Hiring: Title: - RN- Utilization ReviewCity, State: - Milwaukee, -WisconsinLocation: CSM Hosptial MilwaukeeDepartment: -Regional Float PoolAdditional Job Details: .5 FTE Primary hours 8 AM - 4:30 PM (some flexibility)Every other weekend availability and holiday rotationThis is a remote opportunity however, onboarding would be on site.Meetings and any remedial training could require onsite presence.Ascension was recognized in 2021 by Comparably for Best Perks and Benefits, Best Work Life Balance and Best Career Growth. An Ascension Associate will experience the following: - -

  • ABIDE framework: Appreciation, Belongingness, Inclusivity, Diversity, Equity -
  • Competitive compensation packages and 403B plan: -Sign-on Bonuses offered for many positions!
  • Work-life balance: generous paid time off, 8 recognized holidays & well-being programs -
  • Affordable and comprehensive health, prescription drug, vision and dental plans
  • Tuition assistance, educational enrichment & professional development
  • Career Coaching, Leadership Development, Internal Mobility, Job Placement Assistance and more! -
  • Adoption expense assistance, maternity and paternity leave plans -
  • Perks, discounts and much more! 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: Licensed Registered Nurse in the State of WIMinimum 3-5 years RN experience (Inpatient setting and/or UM experience strongly preferred)Experience with Interqual or MCG highly preferredabove average computer literacy skills Why 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: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 Ministry does not participate in E-Verify and therefore cannot employ STEM OPT candidates.

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

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