Connecticut StateDepartment of Administrative Services

Utilization Review Nurse (40 Hour)

Office/On-Site

Recruitment #221123-5612FP-001

Introduction

Are you looking to put your Nursing knowledge to the test? 
If so, we encourage you to apply today! 

ABOUT US: The State of Connecticut, Department of Mental Health and Addiction Services (DMHAS) is a health care agency whose mission is to promote the overall health and wellness of persons with behavioral health needs through an integrated network of holistic, comprehensive, effective, and efficient services and supports that foster dignity, respect, and self-sufficiency in those we serve. 

The Western Connecticut Mental Health Network (WCMHN) was formed in 1996 in order to coordinate clinical, fiscal and administrative oversight of Region 5 contracted and state-operated mental health services. Their mission is to provide a comprehensive and effective recovery-oriented system of mental health and addiction services that promotes self-sufficiency, dignity, cultural sensitivity and respect. Within this service system, there are three state-operated Local Mental Health Authorities, which are located in Waterbury, Danbury and Torrington.  

THE POSITION: We are currently seeking a qualified individual for the position of Utilization Review Nurse. This position is located at 55 West Main Street in Waterbury, CT. Travel to WCMHN's Danbury and Torrington locations will be required to provide routine reviews of medical records. This position is full-time, 40 hours per week, first shift, with a work schedule of 8:00 a.m. to 4:30 p.m., Monday through Friday. The position number is 25022.  

In this role, you will discover the opportunity to: 

  • Be a part of a comprehensive team of caring professionals; 
  • Provide support to hospital that is passionate about improving the lives of those we serve; 
  • Assist our clients and employees so they can achieve success; 
  • Make a difference in the public sector; and 
  • Work together in a collaborative team environment.   
WHAT'S IN IT FOR YOU! We offer a competitive benefits plan that includes healthcare coverage, a retirement plan, as well as paid time off, including 12 paid holidays per calendar year.  We encourage a strong work-life balance for all state employees. We also offer opportunities for professional and personal growth. 

Come join us and make an impaCT as a Utilization Review Nurse for the State of Connecticut!  

Selection Plan

This position may be subject to Federal requirements for COVID-19 Vaccination Immunization.

To Apply:
  • In order to be considered for this job opening, you must meet the Minimum Qualifications as listed on the job opening. The minimum experience and training requirements must be met by the close date on the job opening, unless otherwise specified.
  • You must specify your qualifications on your application. You will be unable to make revisions once you submit your application for this posting to the JobAps system.
  • In order to comply with Public Act 21-69, the State of Connecticut is no longer asking for resumes during the initial application process.
  • All application materials must be received by the recruiting agency by the time specified on the job opening for the position for which you are applying. Late applications may not be submitted and will not be considered. Exceptions are rare and limited to documented events that incapacitate a candidate during the entire duration of the job posting time period. It is the candidate’s obligation and responsibility to request an exception and provide a legally recognized justification to accommodate such exception. Requests should be made to DAS.SHRM@ct.gov.
  • This position will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules.
Important Next Step Information for After You Apply:
  • Although applicants will receive correspondence via email, as a backup they are also encouraged to sign on to their Personal Status Board on a daily basis to monitor their status, view all emailed notices and complete tasks required in the recruitment process.
  • This posting may require completion of additional referral questions (RQs). You can access these RQs via an email that will be sent to you after the posting's closing date or by visiting your JobAps Personal Status Board (Certification Questionnaires section). Your responses to these RQs must be submitted by the question's expiration date. Please regularly check your email and JobAps Personal Status Board for notifications. Please check your SPAM and/or Junk folders on a daily basis in the event an email provider places auto-notification emails in a user's spam.
  • Note: At any point during the recruitment process, applicants may be required to submit additional documentation which support their qualification(s) for this position. These documents may include: a cover letter, resume, transcripts, diplomas, performance reviews, attendance records, supervisory references, licensure, etc., at the discretion of the hiring agency.
  • The immediate vacancy is listed above, however, applications to this recruitment may be used for future vacancies in this job class.
  • Interviews will be limited to candidates whose experience and training most closely meet the requirements of the position.
  • Candidates who are offered and accept a position with the State of Connecticut are bound by the State Code of Ethics for Public Officials and State Employees which is available at www.ct.gov/ethics.
Connect With Us:
  • Due to the large volume of applications received, we are unable to provide confirmation of receipt or status during the recruitment process.
  • Updates will be available through your JobAps portal account. If you have any questions pertaining to this recruitment please contact Doreen Clemson at Doreen.Clemson@ct.gov or 860-785-9855.
#INDHP

PURPOSE OF JOB CLASS (NATURE OF WORK)

In a state agency this class is accountable for a full range of duties involving the assessment and review of health care delivery systems or medical cost containment activities and programs related to agency efforts to promote cost effective quality of care of cost containment in accordance with various federal and/or state statutes, regulations and guidelines.

EXAMPLES OF DUTIES

Performs a variety of duties related to review of various types of health and medical care delivery and reimbursement systems; participates in utilization review and/or quality assurance programs; conducts various types of case reviews for quality and appropriate medical management, cost containment, peer review and rehabilitation; summarizes and analyzes data; prepares statistical reports; implements decisions in program according to revisions in standards; attends professional workshops, seminars and inservice training; maintains up to date knowledge of all changes in relevant discipline; may monitor agency and third party administrator files to oversee contractor handling; monitors personal injuries and medical costs to evaluate need for services billed for appropriate injuries; may review medical records of various health care eligibility, resource unit referral and/or compliance with federal funding provisions; performs related duties are required.

KNOWLEDGE, SKILL AND ABILITY

Considerable knowledge of principles, practices and current trends in nursing; knowledge of and ability to apply relevant state and federal laws, statutes and regulations; knowledge of standards of practice of medicine and nursing as well as other health care disciplines; knowledge of regulations and standards pertaining to utilization review; knowledge of care and service delivery to injured workers; interpersonal skills; oral and written communication skills; ability to analyze patient profile and progress charts to evaluate proper care and treatment.

MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE

Three (3) years experience as a registered professional nurse.

MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE

One (1) year of the General Experience must have been in hospital or institutional nursing, in a medical treatment facility, in rehabilitative or occupational nursing or providing medical review of insurance claims.

MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED

A Bachelor's degree in nursing may be substituted for one (1) year of the General Experience.

PREFERRED QUALIFICATIONS

  • Experience in behavioral health. 
  • Experience with medical cost containments.
  • Experience with programs and delivery of care for specilized populations.
  • Experience with Microsoft Excel and data reporting.

SPECIAL REQUIREMENTS

1. Incumbents in this class must possess and retain a license as a registered professional nurse in Connecticut.
2. Incumbents in this class may be required to travel.

Conclusion

AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER

The State of Connecticut is an equal opportunity/affirmative action employer and strongly encourages the applications of women, minorities, and persons with disabilities.







The State of Connecticut is an Affirmative Action/Equal Opportunity Employer and strongly encourages the application of women, minorities and persons with disabilities.