Registered Nurse Utilization Review

Your future role at a glance

Location: Partially Remote, with onsite coverage required in Baltimore, MD.


Facility: Ascension Saint Agnes Hospital

Department: Utilization Management

Schedule: Day-Shift | Full-Time

Salary: $81,120.00- $115,939.20 per year

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 97,000+ 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.

Benefits that help you thrive

• Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options
• Financial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance
• Time to recharge: pro-rated paid time off (PTO) and holidays
• Career growth: Ascension-paid tuition (Vocare), reimbursement, ongoing professional development and online learning
• Emotional well-being: Employee Assistance Program , counseling and peer support, spiritual care and stress management resources
• Family support: parental leave, adoption assistance and family benefits
• Other benefits: optional legal and pet insurance, transportation savings and more

How you'll make an impact in this role

• Advocate for appropriate care by reviewing admissions and service requests to ensure every patient receives the right level of medical necessity at the right time.
• Guide complex patient journeys through expert case management and consultation, providing a roadmap for high-quality outcomes in even the most challenging clinical situations.
• Support the frontline care team by resolving documentation and reimbursement hurdles, ensuring the hospital can focus its resources on direct patient care.
• Coordinate seamless transitions by collaborating with the healthcare team to build safe, effective discharge plans that set patients up for success long after they leave our facility.
• Maintain clinical integrity by overseeing compliance with federal and payer regulations, protecting our patients and our organization from administrative risk.

What minimum requirements you'll need

Licensure / Certification / Registration:

• Registered Nurse credentialed from the Maryland Board of Nursing 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 preferences we're seeking

• Specialized Expertise: Proven experience in Utilization Management, Case Management, or Clinical Documentation Improvement within a healthcare setting.

Equal employment opportunity employer


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. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

Fraud prevention notice


Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.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 does not participate in E-Verify and therefore cannot employ STEM OPT candidates.

Responsibilities

• Advocate for appropriate care by reviewing admissions and service requests to ensure every patient receives the right level of medical necessity at the right time.
• Guide complex patient journeys through expert case management and consultation, providing a roadmap for high-quality outcomes in even the most challenging clinical situations.
• Support the frontline care team by resolving documentation and reimbursement hurdles, ensuring the hospital can focus its resources on direct patient care.
• Coordinate seamless transitions by collaborating with the healthcare team to build safe, effective discharge plans that set patients up for success long after they leave our facility.
• Maintain clinical integrity by overseeing compliance with federal and payer regulations, protecting our patients and our organization from administrative risk.

Qualifications

Licensure / Certification / Registration:

• Registered Nurse credentialed from the Maryland Board of Nursing 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.