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Appeals Nurse ARRMC (Utilization Management)

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Req #: 8509
Entity: Asante Rogue Regional Medical Center
Location: Medford, OR
Department: Utilization Management
Shift: 1st Shift - Days
Union Position: No
FTE: 0.500000
Schedule: Part Time
Salary: $39.14 - $53.81 depending on qualifications

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Appeals Nurse ARRMC (Utilization Management)


Position Summary

The Appeals Nurse works under the direction of the department director, applies clinical expertise as well as knowledge of utilization management principles and level of care criteria sets to identify issues and problems that may adversely impact quality patient care, appropriate utilization of hospital resources, or optimal financial reimbursement. Medical necessity and administrative denials issued by insurance carriers and/or government entities are evaluated for financial risk to either appeal or use as educational opportunities.

We offer remote opportunities based on your level of experience.

Please Note: While working remotely may be an option - due to our pay practices, qualified candidates MUST reside within one of the following states: OR, WA, CA, NV, CO, AZ, ID, KY, TN, GA, NC, OK, TX, MA, PA, FL, ME, ND, MO, and IL. While candidates need to live or relocate to one of the aforementioned states, working remotely will require reliable broadband internet and personal cell phone service. Remote work may include working day-to-day operations during Pacific Standard business hours or online training.

Qualifications

Education

  • Bachelor's degree in Nursing, or Allied Health field, or equivalent is required

Licensure/Certifications

  • RN: Registered Nurse licensed by Oregon State Board of Nursing (OSBN) required upon start
  • CCM: Certified Case Manager preferred

Experience

  • 1 year or more of Utilization Review experience

What We Offer

  • Competitive starting wage
  • Comprehensive benefits including medical, dental, vision, and wellness
  • Excellent retirement package with up to 6% employer contribution
  • Generous Earned Time Off
  • Tuition reimbursement after one year of service

Why Asante

Asante is more than a great hospital system in an amazing location. We are a community of passionate providers and service-focused caregivers who collaborate to deliver amazing patient outcomes; a place where titles don't matter as much as your creativity, drive, and passion. Our culture, values and people create an environment of sustained medical excellence.

More About Asante and Southern Oregon

Asante is a local, community owned and governed, not-for-profit organization that provides comprehensive health care services to more than 550,000 people in a nine-county area of Southern Oregon and Northern California. It includes Asante Ashland Community Hospital in Ashland, Asante Rogue Regional Medical Center in Medford, Asante Three Rivers Medical Center in Grants Pass, Asante Physician Partners throughout the Rogue Valley, and additional health care partnerships. Virtually all medical specialties and services are represented within an organization dedicated to providing exceptional care. With over 5,000 employees, Asante's entities offer outstanding opportunities for career advancement and professional growth. At Asante your work positively impacts your family, friends, neighbors and the community. Experience the difference in how you work, how you live and how you connect.

At Asante we are defined by our values - traits that guide us as we serve patients and the community:

Excellence - Respect - Honesty - Service - Teamwork

Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.

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