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Registered Nurse (RN) - Utilization Review

We Are Hiring

RN-Utilization Review - ED Trauma Admin - Full-Time,Day - Ascension St. John Hospital - 34030 - Detroit,MI

Monday - Friday Day shift (700a-3:30p or 800a-4:30p)

Why Join Ascension?

In Michigan, Ascension operates 16 hospitals and hundreds of related healthcare facilities that together employ over 20,000 associates. Across the state, Ascension Michigan is working together to help bring patients more resources and better care. Ascension Michigan is also committed to its community; it provided over $272 million in community benefit and care of persons living in poverty in FY2018. Ascension Michigan is dedicated to spiritually centered, holistic care which sustains and improves the health of individuals and communities.

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 Ascension Michigan, 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):
    • Registered Nurse credentialed from the Michigan Board of Nursing obtained prior to hire date or job transfer date. 
    • BLS, ACLS, PALS and TNCC preferred

Education:

  • Diploma 
    • Diploma from an accredited school/college of nursing required, BSN preferred.

Work Experience:

  • Minimum of 5 years clinical experience in trauma, emergency, intensive care preferred.
  • Data extraction, trauma registry, chart analyzation and/or clinical outcomes experience a plus.

Equal Employment Opportunity

Ascension Michigan is an equal opportunity and affirmative action employer. We provide equal employment opportunities to all associates and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, height, weight, genetic information, marital status, amnesty, veteran status or any other legally protected status in accordance with applicable federal, state and local laws. The information requested on this application will not be used for any purpose prohibited by law. If you require assistance or an accommodation to complete this application, please let us know.
 
For further information regarding your EEO rights, click on the following link to the “EEO is the Law” poster:
M/F/Disabled/Vet
 
 
Reasonable Accommodation
Ascension Michigan provides reasonable accommodation so that qualified applicants with a disability may participate in the selection process. Please advise us of any accommodations you request in order to express interest in a position by e-mailing: reasonableaccommodations@stjohn.org. Please state your request for assistance in your message. Only reasonable accommodation requests related to applying for a specific position within Ascension Michigan will be reviewed at the e-mail address supplied.
Thank you for considering a career with Ascension Michigan.
 
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

Ascension Michigan 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: 368959
Category: Nursing
Facility: MIDET Ascension St John Hosp
Ministry: Ascension SE Michigan, MI
Location: Detroit, MI

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