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+ **Department:** Utilization Management

+ **Schedule:** Hybrid work schedule available. Monday-Friday, 8:00AM-4:30PM.

+ **Hospital:** Ascension St. Agnes Hospital

+ **Location:** Baltimore, MD

+ **Salary:** $103,242.70 - 139,681.30 per year

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 and salary range at the time of the offer._

Responsibilities

Manage effective utilization review processes, including management of patient statusing processes and monitoring of medical necessity review functions for assigned sites.

+ Collaborate with the director to develop and implement quality review programs and key performance indicators for all utilization review activities.

+ Interact with medical, nursing, and executive leadership to facilitate quality based, cost effective patient statusing in the most appropriate setting, in compliance with regulatory and revenue cycle requirements.

+ Oversee day-to-day operations of the department and assists with the budgeting process.

+ Serve as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation.

+ Conduct hiring, training, directing, development and evaluation of staff

Requirements

Licensure / Certification / Registration:

+ Registered Nurse obtained prior to hire date or job transfer date required.

Education:

+ Required professional licensure/certification AND 3 years of experience and 1 year of cumulative leadership experience required.

Work Experience:

+ Two years of related experience is required.

Additional Preferences

+ Must be available as needed to address urgent or time-sensitive issues outside of regular business hours. This includes providing support for on-call situations, troubleshooting problems, and ensuring effective resolution to maintain smooth operations.

Registered Nurse, Certified Case Manager (CCM, ACM, URAC) preferred or willing to obtain within 1 year.

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Why Join Our Team

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.

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 will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.

For further information, view the EEO Know Your Rights (English) (https://www.eeoc.gov/sites/default/files/2022-10/22-088\_EEOC\_KnowYourRights\_10\_20.pdf) poster or EEO Know Your Rights (Spanish) (https://www.eeoc.gov/sites/default/files/2022-10/22-088\_EEOC\_KnowYourRightsSp\_10\_20.pdf) 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.

Pay Non-Discrimination Notice (https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp\_%20English\_formattedESQA508c.pdf)

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.

This Ministry does not participate in E-Verify and therefore cannot employ STEM OPT candidates.