Registered Nurse - RN - Utilization Review at UAB St. Vincent's

Birmingham, Alabama, United States -

Full Time

Start Date

Immediate

Expiry Date

27 Jan, 26

Salary

0.0

Posted On

29 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Utilization Review, Case Management, Discharge Planning, Medical Necessity, Compliance, Coding, Medical Records, Precertification, Reimbursement, Claim Denials, Statistical Analysis, Healthcare Services, Team Coordination, Regulatory Compliance, Patient Care, Consultation

Industry

Hospitals and Health Care

Description

Position Overview Department: Utilization Management Schedule: 4x10's Work Location: Remote Benefits for eligible positions only include: generous paid time off, paid parental leave, Associate Assistance Program, Tuition Reimbursement Program, and more What You Will Do Provide health care services regarding admissions, case management, discharge planning and utilization review. 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: Registered Nurse credentialed from the Alabama Board of Nursing obtained prior to hire date or jobtransfer date required. Education: Diploma from an accredited school/college of nursing and required professional licensure at time of hire. Additional Preferences No additional preferences. About UAB St. Vincent’s UAB St. Vincent’s, a proud part of UAB Medicine, is a trusted provider of health care, serving Alabama for more than 125 years. With five hospitals and numerous clinics, we're a health care community deeply rooted in compassion, service, and respect for all, guided by the rich legacy of the St. Vincent’s name. We're committed to extending kindness and personalized care to patients, their families, and each other. We address the physical, psychological, social, and spiritual needs of our patients. We believe in the power of teamwork and unity, and foster a collaborative spirit among our more than 4,800 employees. As one of Alabama’s best hospitals as recognized by U.S. News & World Report, improving the health and lives of those we serve is at the heart of our mission. Join us in continuing our legacy of service and healing in central Alabama, where we can make a lasting impact together.

Responsibilities

Provide health care services related to admissions, case management, discharge planning, and utilization review. Review admissions and service requests for medical necessity and assist with complex cases and compliance issues.