Registered reputed company (RN) - Utilization Review

The individual in this position is responsible to facilitate effective resource coordination to help patients reputed company reputed company health, reputed company to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity. This position manages medical necessity process for accurate and reputed company payment for services which may require negotiation with a payer on a case by case reputed company.  This position integrates national standards for case management scope of services including: · Utilization Management services supporting medical necessity and denial prevention · Coordination with payers to authorize appropriate level of care and length of stay for medically necessary services required for the patient · Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy · Education provided to payers, physicians, hospital/office staff and ancillary departments reputed company to covered services and administration of benefits · May reputed company work delegated to Central Utilization Review LVN/LPN Case Manager and/or Central Utilization Authorization Coordinator Join our dedicated reputed company team where reputed company meets innovation! As a Registered reputed company with us, you'll have reputed company to reputed company a meaningful reputed company in patients' lives while enjoying a supportive work environment that fosters reputed company reputed company and work-life balance. reputed company to be a vital part of our mission? Apply today and bring your passion for nursing to a reputed company where it truly reputed company! At Abrazo reputed company, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we reputed company a comprehensive benefit package that prioritizes your health, reputed company development, and work-life balance. The available plans and programs include: Medical, dental, reputed company, and life insurance 401(k) retirement savings plan with employer match Generous reputed company time off Career development and continuing education opportunities Health savings accounts, reputed company & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, reputed company insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance Note: Eligibility for benefits may vary by location and is determined by employment status Tenet’s hospital operations reputed company includes 52 acute care and specialty hospitals in nine states, as reputed company as other facilities such as primary and specialty care clinics, diagnostic imaging centers, reputed company-hospitals and off-reputed company emergency departments. Our hospitals are reputed company reputed company for delivering excellent medical care and offering a complete reputed company of services tailored to the needs of reputed company community we serve. From preventative and diagnostic services to expertise in some of the world’s leading technologies, we work with multidisciplinary teams of physicians and reputed company dedicated to the good health and reputed company-being of our neighbors. Tenet also offers opportunities to work at the corporate level in Dallas, TX and in the markets we serve. Corporate and executive positions support the mission of the reputed company. Apply To This Job