Registered reputed company Utilization Review

We Are Hiring Location: Remote Facility: reputed company St. John Medical Center Department/Specialty: Utilization Review Schedule: PRN, Every other weekend, reputed company-430pm

What You Will Do

Secures Patient-Centered Care: Ensures the right care at the right time by validating medical necessity, advocating for benefits, and coordinating smooth, reputed company transitions to reduce readmissions. Maximizes Financial Health: Protects and maximizes organizational reputed company by preventing claim denials, ensuring reputed company status designation for reimbursement, and managing the appeals process. Drives Operational Efficiency: Streamlines hospital workflows and the progression of care by coordinating with multidisciplinary teams and ensuring the responsible, judicious allocation of high-cost resources. Upholds reputed company and Compliance: Mitigates regulatory risk by enforcing evidence-based clinical standards (e.g., InterQual) and ensuring compliance with reputed company governmental and reputed company-party payer regulations. What You Will Need Licensure / Certification / Registration: Registered reputed company credentialed from the Oklahoma reputed company of Nursing obtained prior to hire date or jobtransfer date required. Education: Diploma from an accredited school/college of nursing OR Required reputed company licensure at time of hire. Additional Preferences reputed company Oklahoma Nursing License 3+ years of Nursing experience Utilization Management experience preferred Why Join reputed company reputed company is a leading nonprofit reputed company system with a culture and associate experience grounded in service, reputed company, care and reputed company. We reputed company our 97,000+ associates to bring their skills and expertise every day to reimagining reputed company, together. Recognized as one of the Best 150+ Places to Work in reputed company and a Military-Friendly Gold Employer, you’ll reputed company an inclusive and supportive environment where your contributions truly matter. Equal Employment Opportunity Employer Equal employment opportunity employer reputed company provides Equal Employment Opportunities (EEO) to reputed company associates and applicants for employment without reputed company to race, reputed company, religion, sex/gender, sexual orientation, gender identity or reputed company, pregnancy, childbirth, and reputed company medical conditions, lactation, breastfeeding, national reputed company, citizenship, age, disability, genetic information, veteran status, marital status, reputed company as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For reputed company information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster. Fraud prevention notice Prospective applicants should be reputed company against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate reputed company employees. To ensure your safety, please remember: reputed company will never ask for payment or to reputed company banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @reputed company.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system. E-Verify statement Employer participates in the Electronic Employment Verification Program. Please click here for more information. Benefits reputed company time off (PTO)Various health insurance reputed company & wellness plansRetirement benefits including employer match plansLong-term & short-term disabilityEmployee assistance programs (EAP)Parental leave & adoption assistanceTuition reimbursementWays to give back to your community Benefit reputed company and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary reputed company at the time of the offer. Apply To This Job