Registered Nurse Utilization Review

About the role

Your future role at a glance

Responsibilities

• Advocate for appropriate care by reviewing admissions and service requests to ensure every patient receives the right level of medical necessity at the right time.
• Guide complex patient journeys through expert case management and consultation, providing a roadmap for high-quality outcomes in even the most challenging clinical situations.
• Support the frontline care team by resolving documentation and reimbursement hurdles, ensuring the hospital can focus its resources on direct patient care.
• Coordinate seamless transitions by collaborating with the healthcare team to build safe, effective discharge plans that set patients up for success long after they leave our facility.
• Maintain clinical integrity by overseeing compliance with federal and payer regulations, protecting our patients and our organization from administrative risk.

Requirements

• Licensure / Certification / Registration: Registered Nurse credentialed from the Maryland Board of Nursing obtained prior to hire date or job transfer date required.
• Education: Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire.

Preferences

• Specialized Expertise: Proven experience in Utilization Management, Case Management, or Clinical Documentation Improvement within a healthcare setting.

Benefits

• Schedule: Day-Shift | Full-Time | Monday-Friday 8:00AM-4:30PM | Weekend Rotation once per month.
• Salary range: $81,120.00- $115,939.20 per year

Pay

• Salary range: $81,120.00- $115,939.20 per year

Schedule

• Schedule: Day-Shift | Full-Time | Monday-Friday 8:00AM-4:30PM | Weekend Rotation once per month.

Life at Ascension

Life at Ascension: Where purpose meets opportunity

Equal Employment Opportunity

Equal employment opportunity employer

Fraud Prevention Notice

Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system.