Your future role at a glance Department: Case Management
Schedule: Part time, Days
Hospital: Ascension St Thomas
Location: Remote
****Tennessee RN license is required.
How you’ll make an impact in this role
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 coordinates 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.
What minimum qualifications you’ll need
Licensure / Certification / Registration:
Licensed Registered Nurse credentialed from the Tennessee Board of Nursing or current home state license for multi-state license recognition “Compact State” 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.
What additional requirements you’ll need
#UM2026
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.
SPECIALTIES:
Utilization Review & Management (UR/UM)
