We Are Hiring Are you an experienced RN leader with an expertise in utilization review in a busy hospital setting? We have an outstanding opportunity for you! We are in the process of restructuring our team and have created a brand-new position for the right leader to help lead this effort on the UR side. This is an opportunity to be part of a very special nursing leadership team in a hospital with deep roots in the community. We are known for our warm culture that focuses on treating all people with dignity and serving the underserved. Why Join Ascension? Saint Agnes Healthcare serves the greater Baltimore area and employs more than 3,000 associates. Saint Agnes offers a full range of services through its operation of a 254-bed, full-service teaching hospital, Saint Agnes Medical Group, Seton Imaging Center, and Saint Agnes Foundation. Partnerships throughout the community have positioned Saint Agnes to provide support to individuals when and where they need it most. Saint Agnes strives to ensure the vitality and health of the community. Saint Agnes Healthcare is part of Ascension, a faith-based healthcare organization dedicated to transformation through innovation across the continuum of care. As one of the leading non-profit and Catholic health systems in the US, Ascension is committed to delivering compassionate, personalized care to all, especially those most in need. In FY2018, Ascension provided nearly $2 billion in care of persons living in poverty and other community benefit programs. What You Will Do You will be part of an expanded Nurse Manager team that leads our team of Registered Nurse (RN) Care Managers who provide utilization review and discharge planning for our inpatient units / departments at St. Agnes Hospital. In the past all our Care Managers have been cross-trained in both UR and discharge planning and reported to one leader over the entire department. With the two new Nurse Manager roles we are creating more capacity at the leadership level. There is one Nurse Manager over discharge planning and another over utilization review. Our Care Managers will now specialize in one of these areas to allow for enhanced knowledge / skills in their individual roles. You will work closely with a third leader (MSW not RN) who oversees our Care Management Social Workers. All will roll up to our Director of Care Management / Population Health in a way that ties our inpatient team to our outpatient services. Responsibilities: Educates new staff. Assists with program oversight daily and follows up on observation cases as requested. Assists with analysis of denied days, denial report preparation and trending of denial data and physician performance. Serves as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. Develops staff schedule and revises assignments daily to assure optimal unit coverage and distribution of workload within staffing standards. Covers on units as needed. Serves as a resource for complex case management issues. Other duties as assigned. Maintains professional development. Position Type / Schedule: Full time, benefit eligible Salaried / exempt position Day shift (primarily Monday - Friday but as a leader flexibility is required) What You Will Need Required credentials - needed to be considered for this position: Licensed Registered Nurse credentialed from the Maryland Board of Nursing or current home state license for multi-state license recognition "Compact State" obtained prior to hire date. Certified BLS Provider specializing in Health Service Provider credentialed from the American Heart Association (AHA) obtained prior to hire date. Or military CPR-First Aid training . Graduate of an accredited school of nursing (Associates Degree required, BSN or MSN preferred). A minimum of three years of work experience as a Registered Nurse (RN) is required. A minimum of one year of work experience in care / outcomes management, utilization management, and discharge planning is required. Preferred credentials - What we are really looking for: Experienced leader with successful career in management and / or supervisory roles Ideally, we would like someone who has recently lead a utilization review team in a busy hospital environment. Significant hands-on expertise / experience in utilization management and discharge planning in a hospital setting. Payer experience (health insurance carriers, other third-party payers or health plan sponsors). Successful experience as a leader restructuring or building a team a big plus! Equal Employment Opportunity We are an Equal Opportunity Employer. As an equal opportunity employer, Saint Agnes Hospital does not discriminate on the basis of race, color, national origin, sex, sexual orientation, religion, age, mental or physical disability, marital status, veterans status, military service, or any other legally protected status. 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.