STATE OF CONNECTICUT EXECUTIVE BRANCH JOBS

Utilization Review Nurse (40 Hour)

Office/On-site

Recruitment #230828-5612FP-001

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Introduction


Are you ready to take the next step in your healthcare career?
If so, we have an excellent opportunity for you to join our hospital’s team!

ABOUT US
The State of Connecticut, Department of Mental Health and Addiction Services (DMHAS) is seeking a Utilization Review Nurse to join their team at the Connecticut Mental Health Center. 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. 

HIGHLIGHTS
  • FACILITY: Connecticut Mental Health Center
  • UNIT: Utilization Review Department
  • ADDRESS: 34 Park St, New Haven, CT 06519
  • SCHEDULE: Full-time, 40 hours per week, first shift, Monday through Friday, 8:30am to 5:00pm
  • POSITION NUMBER: 102342
DISCOVER THE OPPORTUNITY TO:
  • Communicate with patients regarding their entitlements (Medicare/Medicaid, private insurance) and ensure all relevant paperwork is signed
  • Work with DAS billing to ensure maximum revenue for inpatient stays
  • Monitor length of stay and work with treatment teams on discharge planning
  • Complete continuous audits/tracers of inpatient documentation in support of Joint Commission standards
  • Attend treatment team meetings and provide feedback on level of care, discharge planning, etc.
WHAT'S IN IT FOR YOU
  • The opportunity to work for a Forbes top company: 'Forbes' State of Connecticut Ranked One of the Best Employers of 2023 - State of CT Receives National Recognition for Offering Job Growth, Competitive Benefits, and Flexible Schedule
  • A Platinum Healthcare Plan, the nation’s best for state employees and dependents, according to a report by Georgetown’s Center on Health Insurance Reform and article by Ellen Andrews, Ph.D., along with comprehensive benefit offerings
  • Extensive pension plan and supplemental retirement offerings
  • Generous paid time off, including 13 paid holidays per calendar year
  • Professional growth and development opportunities
  • A healthy work/life balance to all employees
As a loan forgiveness organization, you may be able to qualify for one or more State or Federal loan forgiveness programs.

            MORE ABOUT US 
            When it opened in 1966, CMHC was part of a new vision: to treat people with mental illness in their communities, to provide a place for researchers from many fields to find new treatments, and to teach professionals in the care of mental illness. The Connecticut Mental Health Center is an urban community mental health center with an exceptional tradition of serving individuals with serious mental illness.



            We welcome you to be a part of a comprehensive team of caring professionals and assist our clients/patients so they can achieve success. You will experience the opportunity to make a difference in the public sector as well as Make an ImpaCT as a Registered Professional Nurse for the State of Connecticut! We encourage you to apply today!

            Watch the video below to learn more about becoming a Nurse with the State of Connecticut!


            Selection Plan

            Please visit our 'Applicant Tips on How to Apply' page.

            FOR THOSE WHO HOLD A RN LICENSE IN A STATE OTHER THAN CONNECTICUT AND WISH TO APPLY FOR A CONNECTICUT LICENSE, PLEASE:

            1. Review the eligibility and documentation requirements for CT license by endorsement of an out-of-state license;
            2. Complete a CT DPH online application online (expand the ‘Public Health Practitioners’ grouping, select ‘Registered Nurse’ and then ‘Start’;
            3. Request verification of your out-of-state license(s) electronically through the National Council of State Boards of Nursing’s: Nursys® System. To send verification of your license(s) to CT, read and agree to the terms, enter your biographic information, select your license type and select ‘SEARCH’. Review the results and select the ‘Next’ button. Check the box next to ‘Connecticut’ and complete the transaction. Once the transaction is completed, you will receive a confirmation email from Nursys and the verification will be available to the DPH. Note that PA and MI verifications are not provided through Nursys. Please contact those state boards for information on obtaining verification.
            WHAT YOU SHOULD KNOW:
            • These positions will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules.
            • 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.
            TO APPLY:
            • Ensure that your application is complete and detailed before submitting it. We are no longer accepting resumes in accordance with PA 21-69. You will not be able to make revisions once your application is submitted into the JobAps system.
            • 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.
            • Please select all shift(s) in which you are willing to work on your application. Failure to indicate the shift(s) may result in not being considered for vacancies in that specific shift.
            IMPORTANT INFORMATION 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.
            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 Ellen Devlin at Ellen.Devlin@ct.gov

            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 with inpatient psychiatric hospitalization
            • Experience with chart audits involving inpatient psychiatric documentation 
            • Experience with Medicare Part B billing requirements
            • Experience with Medicare/Medicaid and commercial insurances (authorizations, billable services, level of care criteria)
            • Experience participating within a multidisciplinary treatment team
            • Experience with discharge focused treatment planning 
            • Experience with Excel

            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.





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