Registered Nurse Utilization Review

Your future role at a glance 

Location: Remote 

Facility: Dell Children's Medical Center - Austin

Department: Utilization Management

Schedule: Days  l  Full-time

Salary range: $78,561.60 - $110,905.60 per year

#UM2026

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 99,000+ 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

Benefit options and eligibility vary by position, scheduled hours and location. Benefits are subject to change at any time. Your recruiter will provide the most up-to-date details during the hiring process.

How you’ll make an impact in this role

• Evaluate medical necessity for admissions and service requests to ensure patients receive the most appropriate care at the right time.
• Lead the discharge planning process by collaborating with the healthcare team to create seamless transitions and safe returns home for patients.
• Navigate complex case management scenarios, providing expert consultation to resolve barriers to care and optimize patient outcomes.
• Ensure full compliance with federal and third-party regulations, protecting the integrity of our clinical services and reimbursement processes.
• Resolve documentation and reimbursement challenges to support the department in reducing claim denials and improving operational efficiency.

What minimum requirements you’ll need

Licensure / Certification / Registration:

• Licensed Registered Nurse credentialed from the Texas Board of Nursing or current home state license for multi-state license recognition "Compact State" 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

• Pediatric Utilization Management experienced required.
• Clinical Licensure: Active and unrestricted Registered Nurse (RN) license or equivalent clinical credential required for medical necessity determination. Compact or TX state license required.
• Utilization Management Expertise: Proven experience applying medical necessity criteria (such as InterQual or Milliman) within a clinical or payer environment.

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.