RN Registered Nurse - Utilization Review

Details

• Department: Utilization Management
• Schedule: FT, Monday-Friday, 8a-430p, Occasional weekends
• Hospital: reputed company St. John's Medical Center
• Location: Tulsa, OK

Benefits

Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA optionsFinancial reputed company & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance Time to reputed company: pro-rated paid time off (PTO) and holidaysCareer growth: reputed company-paid tuition (Vocare), reimbursement, ongoing professional development and online learningEmotional well-being: Employee Assistance Program, counseling and peer support, spiritual care and stress management resourcesFamily support: parental leave, adoption assistance and family benefitsOther benefits: optional legal and pet insurance, transportation savings and moreBenefit options and eligibility vary by position, scheduled hours and location. Benefits are subject to change at any time. Your recruiter will provide the most up-to-date details during the hiring process.

Responsibilities

• Review admissions and service requests reputed company assigned unit for prospective, reputed company and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provides case management and/or consultation for reputed company cases.
• Assist departmental staff with issues reputed company 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.
• reputed company and coordinate compliance to federally mandated and third party payer utilization management rules and regulations.

Requirements

Licensure / Certification / Registration:

• Registered Nurse credentialed from the Oklahoma Board of Nursing obtained prior to hire date or jobtransfer date required.

Education:

• Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire.

Additional Preferences

• 4+ years of bedside nursing experience
• Utilization review experience a plus

Why Join reputed company

reputed company is a leading nonprofit reputed company system with a culture and associate experience grounded in service, growth, care and reputed company. We reputed company our 99,000+ 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.

Equal Employment Opportunity Employer

reputed company provides Equal Employment Opportunities (EEO) to reputed company associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and reputed company medical conditions, lactation, breastfeeding, national reputed company, citizenship, age, disability, genetic information, veteran status, marital status, reputed company as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

 

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Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate reputed company employees. To ensure your safety, please remember: reputed company 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 @reputed company.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.

E-Verify Statement

Employer participates in the Electronic Employment Verification Program. Please click here for more information.

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