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RN- Utilization Review Analyst - Case Management - Waco

Company: Ascension
Location: Waco
Posted on: March 15, 2019

Job Description:

We Are Hiring RN- Utilization Review Analyst - Case Management - Providence Health Center - Waco, TXFull-Time, Day (Monday – Friday 8:00 a.m. – 4:30 p.m.) Why Join Employer/Providence?Providence – TexasProvidence Health Center, part of Employer, is located in West Waco and was founded in 1905 as Waco's first hospital. The campus, which is part of Providence Healthcare Network, includes a 237 bed, acute-care hospital offering the best level of care in virtually every medical discipline. We are one of the largest employers in Waco with over 2,200 employees who are committed to providing compassionate and personalized care to those we serve.At Providence Healthcare Network, we believe serving others gives meaning, purpose and joy to our lives. The Providence mission of compassion is perfected by our vision of excellence and we are consistently awarded for the level of care we provide. Some of the recent awards we are most proud of include:Business of the Year by Mission Waco and Business of the Year by the African American Chamber of CommerceRanked 1st in Texas for Cardiac Surgery and among the top 5 percent in the nation.Designated as a Blue Distinction Center for Knee and Hip Replacements by Blue Cross Blue Shield of TexasAt Providence, our associates are the core of what keeps our ministry thriving. Through interactions with patients, families and visitors, our associates make our mission real. We also value investing into the local community and are committed to giving back and partnering with organizations who are making Waco a great place to live.What Providence Healthcare Network has to offer: Heart of Care: Nurses are at the heart of the care we provide. That's why, at Employer, we invest in our nurses so they can have a positive impact on the people and communities we serve.Front Lines: Nurses are on the front lines of the care we provide, and for that reason, [Health Ministry] prides itself in employing some of the best nurses in [State]. And while we pride ourselves in having some of the most experienced nurses in the state, we always welcome exceptional new nurses who are eager to join usWorking Together: Nurses are at the heart of the care we provide. We work together to achieve a highly collaborative nursing environment that leads to more positive outcomes for you and your patients. We are committed to working together to create change. As you embark on the first step of your nursing career, we'd like to invite you to take it with us.What You Will Do As an Associate with Providence Healthcare Netwk-TX, you will have the opportunity to provide health care services regarding admissions, case management, discharge planning and utilization review.Responsibilities:Reviews admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provides case management and/or consultation for complex cases.Assists departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals.Assesses and coordinates discharge planning needs with healthcare team members.May prepare statistical analysis and utilization review reports as necessary.Oversees and coordinates compliance to federally mandated and third party payer utilization management rules and regulations.What You Will Need Licenses/Certifications/Registration:Required Credential(s):Licensed Clinical Registered Nurse credentialed from the Texas Board of Nursing . Education:Diploma Diploma from an accredited school/college of nursing requiredWork Experience:None required.Case Management and/or Utilization Review Experience PreferredEqual Employment Opportunity Providence Healthcare Network is an Equal Opportunity Employer (EOE M/F/D/V). A mission of compassion.A vision of excellence. Please note that Employer will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Employer will not solicit money or banking information from applicants.

Keywords: Ascension, Mansfield , RN- Utilization Review Analyst - Case Management - Waco, Healthcare , Waco, Texas

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