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, location and salary range at the time of the offer.
Provide strategic direction and oversight of the day-to-day operation of utilization management function within the insurance plan.
Ensure integration of utilization management functions with network strategy and claims processing.Oversee work with provider relations on resolving issues.Manage activities related to staffing, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.Develop systems and process for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to implement and manage comprehensive outpatient and inpatient utilization management programs.Oversee implementation and maintenance of prior authorization codes for all clients.RequirementsLicensure / Certification / Registration:
Registered Nurse obtained prior to hire date or job transfer date required.Education:
Bachelor's degree in nursing or diploma from an accredited school/college of nursing required.Master's degree or combination of Bachelor's degree and experience preferred.
Work Experience:
This position covers Acute Care Management and Recovery Audits and Appeals Departments in the state of Wisconsin.
Must live locally to attend training and meetings as needed.
Why Join Our TeamAscension Wisconsin has been providing rewarding careers to healthcare professionals since 1848. Operating 17 hospital campuses and over 100 related healthcare facilities from Racine to Appleton, you will find opportunities that allow you to create a career path you love, all while delivering compassionate, personalized care to the communities we serve.
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 EmployerAscension 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.
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
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.