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We Are Hiring

RN-Utilization Review - Case Management 001 - Full-Time,Days - St Vincent's Medical Center - Bridgeport,CT

Why Join Ascension?

St. Vincent's Health Services, in Bridgeport, Connecticut, includes a licensed 473-bed community teaching hospital, a 76-bed inpatient psychiatric facility in Westport, a large multispecialty provider group, and St. Vincent's Special Needs Services. In 2012, and again in 2018, St. Vincent's achieved Magnet Recognition by the American Nurses Credentialing Center (ANCC), the highest national honor for nursing excellence. Known throughout the region for exceptional cardiovascular care, St. Vincent's specializes in primary care, breast health, obstetrics, emergency medicine, behavioral health, cancer care, bariatric, and orthopedics. St. Vincent's was founded in 1903 by the Daughters of Charity.

St. Vincent's Health Services is part of Ascension, a faith-based healthcare organization dedicated to transformation through innovation across the continuum of care. As one of the leading non-profit and Catholic health systems in the U.S., Ascension is committed to delivering compassionate, personalized care to all, especially to those most in need. In FY2018, Ascension provided nearly $2 billion in care of persons living in poverty and other community benefit programs.

What You Will Do

As an RN Registered Nurse - Utilization Review with St. Vincent's Health Services, 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):
* Registered Nurse obtained prior to hire date or job transfer date.

Education:

* High school diploma/GED with 2 years of experience, or Associate's Degree, or Bachelor's Degree REQUIRED

Work Experience:

* 3 years of experience PREFERRED

E-Verify Statement

To comply with federal regulations of the Immigration Reform and Control Act (IRCA), all employees are required to complete an Employment Eligibility Verification form (I-9). This law applies to all hires including volunteers and students.

St. Vincent's Health Services participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.

E-Verify (link to E-verify site)
Associated topics: ambulatory, bsn, coronary, intensive, intensive care, nurse clinical, nurse rn, recovery, registered nurse, transitional

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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