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Ascension Health Registered Nurse (RN) - Utilization Review - Acute Rehab Administration in Southfield, Michigan

We Are Hiring

Registered Nurse (RN) - Utilization Review - Acute Rehab Administration

Ascension Providence, Southfield Campus

Schedule: PRN 'as needed', M-F, Days

This is not a benefit eligible position

Ascension Providence Hospital - Southfield is a full-service hospital with 24/7 emergency care, a Level II Trauma Center, and a Primary Stroke Center. We deliver advanced surgical care for serious and life-threatening injuries and illnesses.

Ascension Providence Hospital - Southfield is a destination for specialty care.

Preferred Skills:Excellent communication skills (verbal and written). Experience working in a team environment. Computer skills required, prior experience with electronic medical record systems preferred. Ability to adapt to unpredictable situations within the work setting. Demonstrated leadership, effective communicator, and excellent critical thinking skills

Experience Preferred:

  • Experience with QIs and IRF-PPS, preferred

  • Preferred a minimum of 1-2 years of experience in rehabilitation.

  • Previous experience in commercial insurance, Medicare, and Medicaid, preferred.

What We Offer You:

· Competitive compensation· Professional development· Wellbeing programs and holistic growth opportunities

What You Will Do

Provide health care services regarding admissions, case management, discharge planning and utilization review.

  • Review admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provide case management and/or consultation for complex cases.

  • Assist departmental staff with issues related 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.

  • Oversee and coordinate compliance to federally mandated and third party payer utilization management rules and regulations.

What You Will Need

Licensure / Certification / Registration:

  • Registered Nurse credentialed from the Michigan Board of Nursing obtained prior to hire date or job transfer date required.

Education:

  • Diploma from an accredited school/college of nursing required.

Additional Preferences

No additional preferences.

Why Join Our Team

Ascension Michigan employs over 20,000 compassionate caregivers across 16 hospitals and hundreds of related healthcare facilities. Our care teams are dedicated to providing spiritually centered, holistic care which sustains and improves the health of the communities we serve. We provide generous paid time off for work-life balance, a collaborative work environment, professional development opportunities and more to help our associates flourish personally and professionally. If you are looking for a rewarding career in healthcare, we invite you to apply today.When you join Ascension, you join a team of over 160,000 individuals across the country committed to a Mission of serving others and providing compassionate, personalized care to all. Our inclusive culture, continuing education programs, career coaches and benefit offerings are just a few of the resources and tools that team members can use to create a rewarding career path. In fact, Ascension spent nearly $46 million in tuition assistance alone to support associate growth and development. If you are looking for a career where you can grow and make a difference in your community, we invite you to join our team today.

Equal Employment Opportunity Employer

Ascension SE Michigan is an Equal Employment Opportunity (EEO) and Affirmative Action employer. Associates and Applicants receive fair and impartial consideration without regard to race, color, religion, national origin, gender identity, sexual orientation, age, physical or mental disability, veteran status, genetic data, or other legally protected status.Pay Non-Discrimination Notice: https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdfFor further information regarding your EEO rights, click on the following link to the “EEO is the Law” poster:http://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdfEEO is the Law Poster Supplemen (http://www.dol.gov/ofccp/regs/compliance/posters/pdf/ofccp_eeo_supplement_final_jrf_qa_508c.pdf) tPlease note that Ascension 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. Ascension will not solicit money or banking information from applicants.

This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.E-Verify (https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf)

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