Registered Nurse Utilization Review

Job description

Your future role at a glance
• Location: Partially Remote, with onsite coverage required in Baltimore, MD.
• Facility: Ascension Saint Agnes Hospital
• Department: Utilization Management
• Schedule: Day-Shift | Full-Time

How you’ll make an impact in this role
• Advocate for appropriate care by reviewing admissions and service requests to ensure every patient receives the right level of medical necessity at the right time.
• Guide complex patient journeys through expert case management and consultation, providing a roadmap for high-quality outcomes in even the most challenging clinical situations.
• Support the frontline care team by resolving documentation and reimbursement hurdles, ensuring the hospital can focus its resources on direct patient care.
• Coordinate seamless transitions by collaborating with the healthcare team to build safe, effective discharge plans that set patients up for success long after they leave our facility.
• Maintain clinical integrity by overseeing compliance with federal and payer regulations, protecting our patients and our organization from administrative risk.

What minimum requirements you’ll need
Licensure / Certification / Registration:
• Registered Nurse credentialed from the Maryland Board of Nursing 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.

Additional Preferences:
• Specialized Expertise: Proven experience in Utilization Management, Case Management, or Clinical Documentation Improvement within a healthcare setting.
• Monday-Friday 8:00AM-4:30PM, Weekend Rotation once per month.

Benefits that help you thrive
Benefits that help you thrive
• Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options
• Financial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance
• Time to recharge: pro-rated paid time off (PTO) and holidays
• Career growth: Ascension-paid tuition (Vocare), reimbursement, ongoing professional development and online learning
• Emotional well-being: Employee Assistance Program, counseling and peer support, spiritual care and stress management resources
• Family support: parental leave, adoption assistance and family benefits
• Other benefits: optional legal and pet insurance, transportation savings and more

*Benefit 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.
Life at Ascension: Where purpose meets opportunity
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 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
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) poster or EEO Know Your Rights (Spanish) poster.
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E-Verify statement
Employer does not participate in E-Verify and therefore cannot employ STEM OPT candidates.