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Registered Nurse - RN - Utilization Review - PRN

We Are Hiring

RN - Utilization Review - Utilization Management 001 - PRN, Rotating – Ascension St. Vincents Health System - Jacksonville, FL

Jacksonville, Florida, known as Jax to the locals, offers 22 miles of beaches, the largest urban park system in the country, and extraordinary cultural and historical spots. The city is known for its craft breweries, local coffee shops, and it’s love for football. Go Jags!  Jacksonville is the 3rd fastest growing city in the country and is ranked a top 10 places for millennials to move. Jacksonville was also just named one of Expedia’s 2018 “21 Supercool U.S. Cities”. From world-class fishing, golfing and amazing coastal cuisines to beautiful, historic neighborhoods and exciting nightlife – Jacksonville has something for everyone and is a great place to call home. As a melting pot of cultures and races since 1564, Jacksonville is proud of its vast heritage and culture and is a welcome spot for all.  With over 500 neighborhoods within Jacksonville, you are sure to find the perfect place for you.

Ascension St. Vincent Medical Center Riverside has 528 beds, and is home to the largest cardiovascular program between Atlanta and Orlando. We are proud to partner with the Mayo Clinic to bring its expertise in cancer care to Riverside. In the past few years, we have received several notable awards including:

•Top 5 performer in knee replacements by Consumer Reports

•America’s 100 Best for Spinal Surgery by Health grades

•Repeated ‘A’ rated patient safety scores from the Leapfrog Group

As an Associate with St. Vincent's HealthCare-FL, you will have the opportunity to provide health care services regarding admissions, case management, discharge planning and utilization review.

Shift:  PRN with weekend requirement

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.

Minimum Qualifications:

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

Preferred Qualifications:

  • 1 year of relevant work experience

Equal Employment Opportunity

St. Vincent's Healthcare (SVHC) will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.
 
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.

E-Verify Statement

To comply with federal regulations of the Immigration Reform and Control Act (IRCA), all employees are required to complete an Employment Eligibility Verification form (I-9).  This law applies to all hired individuals regardless of schedule and hours, including volunteers and students. 
 

St. Vincent's HealthCare participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.

E-Verify (link to E-verify site)

 
 
Job ID: 351064
Category: Nursing
Facility: FLJAC St Vincents Hlth System
Ministry: Ascension St. Vincent's, FL
Location: Jacksonville, FL

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