RN Registered Nurse - Utilization Review
Ascension
- Wichita, KS
- Permanent
- Full-time
- Department: Utilization Review - Behavior Health
- Schedule: PRN, Day Shift, Rotating Weekends and Holidays
- Hospital: Ascension Via Christi St Joseph
- Location: Wichita Kansas
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community*Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: Travel, PRN, Short-Term Option, etc.). Actual compensation offer will vary based upon role, education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics.ResponsibilitiesProvide 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.
- Licensed Registered Nurse credentialed from the Kansas Board of Nursing required.
- Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire.