Registered Nurse Utilization Review

Location: Jacksonville, FL | Facility: Remote | Ascension St. Vincent's Riverside Hospital

About the Role

Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care, and connection. We empower our 97,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter.

Responsibilities

• Lead the end-to-end medical necessity review process, ensuring admissions and service requests meet all reimbursement and compliance criteria.
• Provide expert case management and consultation for high-complexity cases to optimize patient outcomes.
• Resolve departmental hurdles related to coding, documentation, and precertification while navigating the claims and appeals process.
• Strategize with the healthcare team to assess and execute seamless discharge plans tailored to patient needs.
• Spearhead compliance with federal and third-party payer regulations, leveraging data and utilization reports to drive operational excellence.

Requirements

• Licensed Registered Nurse obtained prior to hire date or job transfer date.
• Licensed as a Registered Nurse in Florida.
• Credentialed from State Board of Nursing or current home state license for multi-state license recognition "Compact State" obtained prior to hire date or job transfer date.
• Diploma from an accredited school/college of nursing OR required professional licensure at time of hire.

Benefits

• Comprehensive health coverage: medical, dental, vision, prescription coverage, and HSA/FSA options.
• Financial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance.
• Time to recharge: pro-rated paid time off (PTO) and holidays.
• Career growth: Ascension-paid tuition (Vocare), reimbursement, ongoing professional development, and online learning.
• Emotional well-being: Employee Assistance Program, counseling and peer support, spiritual care, and stress management resources.
• Family support: parental leave, adoption assistance, and family benefits.
• Other benefits: optional legal and pet insurance, transportation savings, and more.

Pay

Salary Range: $84,060.91 - $118,668.99

Schedule

Days | Full-time