Back to Jobs search

Utilization Review Nurse

Ascension Health • Nashville, TN • 2h ago

Your future role at a glance

Location: Remote

Facility: Saint Thomas Rutherford

Department: Utilization Management

Schedule: PRN | Days

Salary Range: $33.99 - $63.98 per hour

Life at Ascension: Where purpose meets opportunity

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.

Benefits that help you thrive

Retirement: 403(b) plan

Well-being support: Employee Assistance Program, counseling and peer support, spiritual care and stress management resources

How you'll make an impact in this role

Admissions & Medical Necessity Review: Evaluating service requests and admissions for medical necessity using evidence-based tools (like InterQual) to ensure they comply with reimbursement policies.

Case Management & Consultation: Providing coordination and consultation for complex cases to enhance clinical outcomes and manage the cost of care.

Administrative & Billing Support: Assisting staff with medical documentation, coding, precertification, and managing claim denials or appeals.

Discharge Planning: Assessing and coordinating a patient's post-hospital needs, such as home health, medical equipment, or transfers to skilled nursing facilities.

What minimum requirements you'll need

Licensure / Certification / Registration:

Licensed Registered Nurse credentialed from the Tennessee Board of Nursing or current home state license for multi-state license recognition "Compact State" 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.

Equal employment opportunity employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all 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) (https://www.eeoc.gov/sites/default/files/2023-06/22-088\EEOC\KnowYourRights6.12.pdf) poster or EEO Know Your Rights (Spanish) (https://www.eeoc.gov/sites/default/files/2023-06/22-088\EEOC\KnowYourRightsSp6.12.pdf) poster.

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.

E-Verify statement

Employer participates in the Electronic Employment Verification Program. Please click here (https://www.e-verify.gov/about-e-verify) for more information.

Similar Jobs

Diagnostic Radiologic Technologist (Cardiac Cath Lab)

Veterans Affairs, Veterans Health Administration • Nashville, TN • 54min ago

Hospital & Medical

Summary The position is in the Medical Imaging Department, Patient Care Service, at the Tennessee Valley Healthcare System where the incumbent performs a variety of routine and very difficult radiographic examinations an...

54min ago

Go to Apply

Physician (Assistant Chief of Staff)

Veterans Affairs, Veterans Health Administration • Nashville, TN • 58min ago

Hospital & Medical

Summary The Assistant Chief of Staff for Clinical Operations provides executive leadership, administrative oversight, and clinical guidance across all clinical programs within the Tennessee Valley Healthcare System. The...

58min ago

Go to Apply

Health Information Specialist I-Entry Level-7513

Datavant • Nashville, TN • 20h ago

Hospital & Medical

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the...

20h ago

Go to Apply

Clinical | RN: Rehab - Contract - Nights

HealthTrust Workforce Solutions • Gallatin, TN • 1d ago

Hospital & Medical

Grow Your Career with HealthTrust & Lifepoint Health Looking to expand your nursing career in a new location? HealthTrust Workforce Solutions has partnered with Lifepoint Health to provide travel nurse opportunities...

1d ago

Go to Apply

Clinical | RN: Behavioral Health - Contract - Nights

HealthTrust Workforce Solutions • Gallatin, TN • 1d ago

Hospital & Medical

1d ago

Go to Apply

Health Information Specialist 1

Datavant • Nashville, TN • 1d ago

Hospital & Medical

1d ago

Go to Apply

Actuary - Primary Care Organization

CenterWell • Nashville, TN • 1d ago

Hospital & Medical

Become a part of our caring community The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Esta...

1d ago

Go to Apply

Registered Nurse Coordinator

Ascension Health • Nashville, TN • 1d ago

Hospital & Medical

Your future role at a glance Location: Nashville, TN Facility: Ascension Saint Thomas West Department: Renal Transplant Services Schedule: Full-time | Day Shift Life at Ascension: Where purpose meets opportunity Ascensio...

1d ago

Go to Apply

Veterinary Medical Director

BluePearl • Nashville, TN • 1d ago

Hospital & Medical

BluePearl Pet Hospital located in Nashville, TN is seeking a collaborative, engaged, and passionate veterinary leader with several years of clinical experience to lead our team of emergency and specialty clinicians in th...

1d ago

Go to Apply

Staff Clinical Consultant

Oracle • Nashville, TN • 1d ago

Hospital & Medical

Job Description Responsible for driving the client through the design of clinical and business processes, solution and technology workflow, and successful adoption that will lead to achieved value. Manage ongoing relatio...

1d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)