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RN - Utilization Review

Company: Ascension (System Office)
Location: Austin
Posted on: September 13, 2019

Job Description:

We Are Hiring

RN-Utilization Review

Full-Time, Days

Monday -Friday 8am-5pm

Chevy Chase Building - Austin, TX

Why Join Ascension?

Ascension Seton, based in Austin, Texas, is a faith-based non-profit healthcare system founded in 1902 by the Daughters of Charity. Called to be a sign of God's unconditional love for all, Ascension Seton strives to expand access to high-quality, low-cost, person-centered care and services. Ascension Seton operates more than 100 clinical locations, including four teaching hospitals which serve as training sites for Dell Medical School at The University of Texas.

Ascension is a faith-based healthcare organization dedicated to transformation through innovation across the continuum of care. As one of the leading non-profit and Catholic health systems in the U.S., Ascension is committed to delivering compassionate, personalized care to all, especially to those most in need. In FY2018, Ascension provided nearly $2 billion in care of persons living in poverty and other community benefit programs.

What You Will Do

As an associate with the Seton Family of Hospitals-TX, you will have the opportunity to provide health care services regarding admissions, case management, discharge planning and utilization review.

Responsibilities:

* 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
* Diploma from an accredited school/college of nursing required



Work Experience:

* None required.

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.pdf

EEO is the Law Poster Supplement

http://www.dol.gov/ofccp/regs/compliance/posters/pdf/ofccp_eeo_supplement_final_jrf_qa_508c.pdf

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 (System Office), Austin , RN - Utilization Review, Healthcare , Austin, Texas

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