Position Overview
Department: Utilization Review
Schedule:
PRN Days Work
Location:
UAB ST Vincent's Birmingham Benefits for eligible positions only include: generous paid time off, paid parental leave, Associate Assistance Program, Tuition Reimbursement Program, and more
What You Will Do
- 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 coordinate 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 You Will Need
Licensure / Certification / Registration: Licensed Associate Professional Registered Nurse credentialed from the Alabama Board of Nursingobtained prior to hire date or job transfer date required.
Education:
- Diploma from an accredited school/college of nursing and required professional licensure at time of hire.
- One Year of Experience is required Additional Preferences No additional preferences.
- About UAB St.
- Vincent’s UAB St.
- Vincent’s, a proud part of UAB Medicine, is a trusted provider of health care, serving Alabama for more than 125 years.
- With five hospitals and numerous clinics, we're a health care community deeply rooted in compassion, service, and respect for all, guided by the rich legacy of the St.
- Vincent’s name.
- We're committed to extending kindness and personalized care to patients, their families, and each other.
- We address the physical, psychological, social, and spiritual needs of our patients.
- We believe in the power of teamwork and unity, and foster a collaborative spirit among our more than 4,800 employees.
- As one of Alabama’s best hospitals as recognized by U.S.
- News & World Report, improving the health and lives of those we serve is at the heart of our mission.
- Join us in continuing our legacy of service and healing in central Alabama, where we can make a lasting impact together.
