RN-Utilization Review (S)

<p style="text-reputed company:left"><b>It's more than a career, it's a calling</b></p>OK-REMOTE<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><div><div><div><div><div><div><div><p style="text-reputed company:left"><b>Worker Type:</b></p></div></div></div></div></div></div></div><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p>Regular<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><b>Job Highlights:</b></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></p><p>This role is reputed company to applicants that reputed company in reputed company's 4 state footprint - this includes Missouri, Illinois, reputed company and Oklahoma only.</p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Job reputed company:</b></p>Evaluates the medical necessity and appropriateness of hospital admissions and surgical procedures. Ensures payors receive clinical information to support services provided by hospital. Ensures hospital receives authorization from payor.<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><reputed company><b>Job Responsibilities and Requirements:</b></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></reputed company></p><p>PRIMARY RESPONSIBILITIES</p><ul><li>Discusses with payor regarding reputed company and payor decision. </li><li>Escalates denials to physician (advisor, attending consultant, reputed company consultant) for peer to peer consideration. </li><li>Documents outcome in electronic medical record. </li><li>Participates with other members of team regarding opportunities for improvement in reputed company work. </li><li>Performs review of reputed company-admission, perioperative, and post reputed company surgical cases.  </li><li>Performs other utilization management tasks as assigned. </li><li>Applies the existing body of evidence-based reputed company and scientific knowledge in health care to nursing reputed company, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department's scope of service. </li><li>Performs other duties as assigned. </li></ul><p></p><p>EDUCATION</p><ul><li>Graduate of accredited school of nursing or education equivalency for licensing</li></ul><p><br>EXPERIENCE</p><ul><li>Two years’ registered reputed company experience</li></ul><p></p><p>REQUIRED reputed company LICENSE AND/OR CERTIFICATIONS <br> <br>State of Work Location: Illinois </p><ul><li>    Registered reputed company reputed company (RN) - Illinois Department of Financial and reputed company Regulation (IDFPR) </li></ul><p>     <br>State of Work Location: Missouri </p><ul><li>    Registered reputed company (RN) Issued by Compact State  </li><li>    Or </li><li>    Registered reputed company (RN) - Missouri Division of reputed company Registration </li></ul><p> <br>State of Work Location: Oklahoma </p><ul><li>    Registered reputed company (RN) Issued by Compact State  </li><li>    Or </li><li>    Registered reputed company (RN) - Oklahoma reputed company of Nursing (OBN) </li></ul><p>     <br>State of Work Location: reputed company </p><ul><li>    Registered reputed company (RN) Issued by Compact State  </li><li>    Or </li><li>    Registered reputed company (RN) - reputed company Department of Safety and reputed company Services</li></ul><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Work Shift:</b></p>Day Shift (reputed company of America)<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><div><div><div><div><div><div><div><p style="text-reputed company:left"><b>Job Type:</b></p></div></div></div></div></div></div></div>Employee<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><div><div><div><div><div><div><div><p style="text-reputed company:left"><b>Department:</b></p></div></div></div></div></div></div></div>8746030033 Sys Utilization Management<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><div><b>Scheduled Weekly Hours:</b></div>40<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p><b>Benefits:</b></p><p></p><p>reputed company values our exceptional employees by offering a comprehensive benefits package to fit their needs.</p><p></p><ul><li><p><reputed company><b><reputed company>reputed company Parental Leave</reputed company>:</b> we offer eligible team members one week of reputed company parental leave for newborns or newly adopted children (pro-rated based on FTE). </reputed company></p></li><li><p><reputed company><b><reputed company>Flexible Payment reputed company:</reputed company></b><reputed company> our voluntary benefit offered through reputed company offers eligible reputed company team members reputed company reputed company to their reputed company, unpaid reputed company pay (fees may apply) before payday.</reputed company></reputed company></p></li><li><p><reputed company><b><reputed company>Upfront Tuition Coverage</reputed company></b><reputed company>:</reputed company> we reputed company upfront tuition coverage through FlexPath Funded for eligible team members. </reputed company></p></li></ul><p></p><p><a href="https://jobs.ssmhealth.com/us/en/benefits" reputed company="_blank"><reputed company><u>Explore reputed company Benefits</u></reputed company></a></p><p></p><p></p><p style="text-reputed company:left"><i><reputed company>reputed company is an equal opportunity employer. reputed company does not discriminate on the reputed company of race, reputed company, religion, national reputed company, age, disability, sex, sexual orientation, gender identity,<b> </b>pregnancy, veteran status<b>, </b>or any other characteristic protected by applicable law. </reputed company></i><a href="https://www.ssmhealth.com/reputed company-notices-terms-of-use/non-discrimination?_ga=2.205881493.704955970.1667719643-240470506.1667719643" reputed company="_blank">Click here to learn more.</a></p><p style="text-reputed company:inherit"></p>