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RN, Utilization Review - Full Time

Saint Luke's Health System Kansas CityKansas City, MO
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Overview

Schedule
Full-time
Education
Nursing (RN, LPN)
Career level
Entry-level
Remote
On-site
Benefits
Paid Vacation
Career Development
Health & Wellness Programs

Job Description

Job Description

The Opportunity:

The Utilization Review RN is responsible for assuring the receipt of high quality, cost efficient medical outcomes through utilization review and management. This position includes monitoring patient charts and utilization of health care services. Collaborates and communicates with physicians, Care Coordinators, Social Workers and other members of the multidisciplinary and revenue cycle teams.

  • Completes initial and concurrent reviews; identifies appropriate level of service and length of stay, using clinical guidelines (InterQual).

  • Complies with CMS regulation regarding utilization review/management.

  • Obtains and manages insurance authorizations and proactively works denials to help mitigate financial impact.

  • Submits referrals for secondary level review as appropriate and follows through on process.

  • Documents communication and work in electronic medical record.

  • Works with physicians and members of the multidisciplinary and revenue cycle teams to ensure appropriate level of service, level of care and billing.

Why Saint Luke's?

  • We believe in work/life balance.

  • We are dedicated to innovation and always looking for ways to improve.

  • We believe in creating a collaborative environment where all voices are heard.

  • We are here for you and will support you in achieving your goals.

Requirements include a Kansas and Missouri Nursing License, as well as an associates degree. Prefer Case Management or Utilization Review experience, a strong medical surgical background, and a BSN.

Job Requirements

Applicable Experience:

1 year

Registered Nurse (MO) - National Council of State Boards of Nursing (NURSYS)

Associate Degree

Job Details

Full Time

Day (United States of America)

The best place to get care. The best place to give care. Saint Luke's 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.

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FAQs About RN, Utilization Review - Full Time Jobs at Saint Luke's Health System Kansas City

What is the work location for this position at Saint Luke's Health System Kansas City?
This job at Saint Luke's Health System Kansas City is located in Kansas City, MO, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
What pay range can candidates expect for this role at Saint Luke's Health System Kansas City?
Employer has not shared pay details for this role.
What employment applies to this position at Saint Luke's Health System Kansas City?
Saint Luke's Health System Kansas City lists this role as a Full-time position.
What experience level is required for this role at Saint Luke's Health System Kansas City?
Saint Luke's Health System Kansas City is looking for a candidate with "Entry-level" experience level.
What education level is required for this job?
The education requirement for this position is Nursing (RN, LPN). Candidates with relevant qualifications or equivalent experience may also be considered.
What benefits are offered by Saint Luke's Health System Kansas City for this role?
Saint Luke's Health System Kansas City offers following benefits: Paid Vacation, Career Development, and Health & Wellness Programs for this position. Actual benefits may vary depending on the employer's policies and employment terms.
What is the process to apply for this position at Saint Luke's Health System Kansas City?
You can apply for this role at Saint Luke's Health System Kansas City either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.