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
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.
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