Utilization Review Nurse - Weekends
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Closing Date:
Type of Position:
Management - Operations
Job Type:
Regular
Work Shift:
Sponsorship Available:
Institution Name:
University of Arkansas for Medical Sciences
The University of Arkansas for Medical Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork and diversity. We champion being a collaborative health care organization, focused on improving patient care and the lives of Arkansans.
UAMS offers amazing benefits and perks (available for benefits eligible positions only):
- Health: Medical, Dental and Vision plans available for qualifying staff and family
- Holiday, Vacation and Sick Leave
- Education discount for staff and dependents (undergraduate only)
- Retirement: Up to 10% matched contribution from UAMS
- Basic Life Insurance up to $50,000
- Career Training and Educational Opportunities
- Merchant Discounts
- Concierge prescription delivery on the main campus when using UAMS pharmacy
Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening. To apply for the position, please click the Apply link/button.
The University of Arkansas is an equal opportunity institution. The University does not discriminate in its education programs or activities (including in admission and employment) on the basis of any category or status protected by law, including age, race, color, national origin, disability, religion, protected veteran status, military service, genetic information, sex, sexual preference, or pregnancy. Questions or concerns about the application of Title IX, which prohibits discrimination on the basis of sex, may be sent to the University’s Title IX Coordinator and to the U.S. Department of Education Office for Civil Rights.Persons must have proof of legal authority to work in the United States on the first day of employment.
All application information is subject to public disclosure under the Arkansas Freedom of Information Act.
For general application assistance or if you have questions about a job posting, please contact Human Resources at askrecruitment@uams.edu.
Department:
ICE | CORE PA Utilization Review Team A
Department's Website:
Summary of Job Duties:
The Utilization Review (UR) RN Care Manager is responsible for utilizing pre-established, evidence based screening criteria to validate the appropriateness of patient admissions, provide screening, and continuous observation status monitoring. The RN Care Manager UR is also responsible for communicating relevant information to appropriate payer carriers regarding a patient’s stay. The role reflects appropriate knowledge of the RN scope of practice, current state requirements, CMS Conditions of Participation, Patient Bill of Rights, AB 1203 and other Federal or State regulatory agency requirements specific to discharge planning.
Qualifications:
Minimum Qualifications:
- Associate’s Degree in Nursing (ADN)
- 5 years of clinical nursing experience
- Valid AR Registered Nursing license.
Preferred Qualifications:
- Certified Case Manager (CCM) or American Case Management (ACM) certification
Additional Information:
Initiates appropriate referrals to internal and external interdisciplinary teams.
Establishes a working diagnosis on every patient at the time of the initial review.
Communicates the target length of stay and estimated discharge on every patient at the time of the initial review and coordinates the discharge planning process in collaboration with the interdisciplinary team.
Documents all team, physician, and payer communication and concerns pertaining to coordinating of care and services.
Responsible for utilizing pre-established evidence-based screening criteria to validate the appropriateness of patient admission and provide appropriate screenings of the patients assigned to a designated coverage area, including initial, continued stay and completion of discharge screens.
Communicates with physicians regarding the level of care or admission status when appropriate criteria are not met for inpatient, observation, or continued stay review.
Escalates appropriate cases to Physician Advisor for secondary review process.
Escalates payer denial/appeal issues to the Physician Advisor/CMO/Attending in a timely fashion.
Other duties as assigned to meet UAMS core values and the business needs of the department.
PHYSICAL REQUIREMENTS
Stand: Frequently
Sit: Frequently
Walk: Occasionally
Bend, crawl, crouch, kneel, stoop or reach overhead: Frequently
Lift and carry weight: 25 lbs
Push and pull weight: 25 lbs
Use hands to touch, handle or feel: Frequently
Talk: Continuously
Hear: Continuously
Taste or smell: Occasionally
Read, concentrate, think analytically: Continuously
Salary Information:
Required Documents to Apply:
Optional Documents:
Special Instructions to Applicants:
Recruitment Contact Information:
Please contact askrecruitment@uams.edu for any recruiting related questions.
All application materials must be uploaded to the University of Arkansas System Career Site https://uasys.wd5.myworkdayjobs.com/UASYS
Please do not send to listed recruitment contact.
Pre-employment Screening Requirements:
Annual TB Screening, Criminal Background Check, Substance Abuse Testing
This position is subject to pre-employment screening (criminal background, drug testing, and/or education verification). A criminal conviction or arrest pending adjudication alone shall not disqualify an applicant except as provided by law. Any criminal history will be evaluated in relationship to job responsibilities and business necessity. The information obtained in these reports will be used in a confidential, non-discriminatory manner consistent with state and federal law.
Constant Physical Activity:
Hearing
Frequent Physical Activity:
Feeling, Manipulate items with fingers, including keyboarding, Sitting, Standing, Talking, Walking
Occasional Physical Activity:
Balancing, Crawling, Crouching, Grasping, Kneeling, Reaching, Stooping
Benefits Eligible:
Yes
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