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Registered Nurse RN – Utilization Review, PT, IL

Remote, USA Full-time Posted 2025-11-24
424592 Details • Department: Utilization Review • Schedule: Part-Time, Partially Remote, Monday - Friday; 9am - 1pm. • Hospital: Ascension Saint Joseph • Location: Partially Remote/Chicago, IL • Salary: $39.66 - $55.99 per hour • *Needs to reside in the Chicago-land area** Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer. Responsibilities 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. Requirements Licensure / Certification / Registration: • Registered Nurse credentialed from the Illinois 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 Valid RN license in Illinois Why Join Our Team Ascension Illinois delivers compassionate, personalized care throughout Chicago and its surrounding suburbs. As one of the largest health systems in Illinois with 15 hospitals and more than 230 sites of care, you will find an environment that allows you to thrive and create a career path you love. Join a diverse team of more than 17,000 associates and more than 600 providers who are dedicated to providing compassionate, personalized care to all. Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states. Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you. 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. As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension. Please 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. E-Verify Statement This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information. Apply tot his job Apply To this Job

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