Utilization Review Nurse Jobs Fully Remote Work

Job Responsibilities : Utilization Review RN – Part Time Weekends – Remote

Salary : $75000 per year

Company : Ascension

Location : Remote US

Additional Job Details: Part-Time, 24 Hours

Saturday and Sunday, 7a-7p
Weekends only

Additional Information:Training: 6 weeks total
First 3 weeks need availability to train during the week
Last 3 weeks, will be training on the weekends

What You Will Do:

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:
Licensed Registered Nurse obtained prior to hire date or job transfer date required.
Diploma from an accredited school/college of nursing required

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