Posted on: January 14, 2019
We Are Hiring RN-Utilization Review - Total Quality Management-Seton Total Health- Full-Time,Day - Quarry Lake - Austin,TXWhy Join Employer? CultureRelational Environment: Employer provides a community of colleagues who listen with openness to their own experiences and to the experiences of others. Working together and sharing experiences builds dedication to each other and our mission.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. Environment of Quality: At Employer, we continually focus on quality measures that impact patient outcomes. As part of an integrated system, our hospitals are designed to treat patients in the care setting most appropriate to their condition.Culture of Service: We provide opportunities for Employer associates to serve in their local communities through our community impact and Medical Missions at Home programs. Just last year, Employer provided over 1.8 billion dollars in free healthcare to the poor and vulnerable through these initiatives.Culture of Creativity: Associates at Employer are encouraged to courageously innovate. Working together and thinking outside of the box - that's how we are transforming healthcare.A Place of Reverence: Working at Employer is more than a job – it's a ministry. Our ministry offers a place where we have deep respect and compassion for the dignity of all, and it starts with our associates.Culture of Advocacy: Employer is a place that advocates for a compassionate and just society in everything we do. Our associates are encouraged to reflect this through word and deed.Appreciation for Diversity: At Employer, we recognize that our workforce should reflect the diversity of those we serve. We offer a place of respect and inclusion for all associates. Respect and inclusion feels good. We are on a mission to help people feel good, patients and associates.What You Will Do As an Associate with Seton Family of Hospitals-TX, you will have the opportunity to:Provide health care services regarding admissions, case management, discharge planning and utilization review.You will:Reviews admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provides case management and/or consultation for complex cases.Assists departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals.Assesses and coordinates discharge planning needs with healthcare team members.May prepare statistical analysis and utilization review reports as necessary.Oversees and coordinates compliance to federally mandated and third party payer utilization management rules and regulations.What You Will Need Licenses/Certifications/Registration:Required Credential(s):Licensed Registered Nurse credentialed from the Texas Board of Nursing . Education:Diploma High school diploma/GED with 2 years of experience, or Associate's degree, or Bachelor's degree requiredWork Experience:3 years of experience preferred.Equal Employment Opportunity Seton Healthcare Family is an equal employment opportunity / Affirmative Action employer and complies with all applicable federal, state and local equal employment regulations and laws. It is the policy of the Seton Healthcare Family to afford equal employment opportunities to all employees and prospective employees without regard to their race, color, ancestry, religion, sex, sexual orientation, national origin, age, physical or mental disability, citizenship status, veteran status, gender identity or expression, or any other characteristic or status that is protected by federal, state, or local laws. This policy applies to all personnel actions, such as hiring, promotion, transfer, demotion, termination, layoff and all other conditions and privileges of employment in accordance with applicable federal, state, and local laws. Affirmative Action goes beyond the concept of equal employment opportunity. Affirmative Action policies and programs are required to overcome the present effects of past discrimination and to achieve equal employment opportunity for members of groups that are or have been formerly under-represented. Affirmative Action policies and programs are tools whereby additional efforts are made to recruit, employ and promote qualified members of formerly excluded groups, even if that exclusion cannot be traced to particular discriminatory actions. Through specific and result-oriented activities, Seton Healthcare Family's goals are to ensure that every person is given full consideration through equal employment opportunity policies and practices and to achieve a representative workforce through its affirmative action efforts. It is further the policy of the Seton Healthcare Family to encourage vendors, contractors, affiliate institutions and others doing business with the Seton Healthcare Family to observe the principles of Equal Employment Opportunity and Affirmative Action. Seton Healthcare Family is an EEO/AA employer: M/F/Disabled/Vet.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.pdfEEO is the Law Poster Supplement http://www.dol.gov/ofccp/regs/compliance/posters/pdf/ofccp_eeo_supplement_final_jrf_qa_508c.pdfPlease note that Employer 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. Employer will not solicit money or banking information from applicants.
Keywords: Ascension, Austin , RN-Utilization Review, Healthcare , Austin, Texas
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