[Hiring] Utilization Review RN @University of Arkansas System

Role Description

This is a full-time position working four 10 hour shifts; (0630-1700) Thursday - Sunday. Must live within one hour of Little Rock campus.

• 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.
• Communicate relevant information to appropriate payer carriers regarding a patient’s stay.
• Reflect 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:
• ADN, or Diploma RN Degree.
• 5 years RN experience with current BLS certification.
• Valid Arkansas Registered Nursing License.
• Preferred Qualifications:
• BSN.
• Certified Case Manager (CCM) or American Case Management (ACM) certification.

Requirements

• 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.
• 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.

Benefits

• 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.

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

Commensurate with education and experience.

Required Documents to Apply

• List of three Professional References (name, email, business title).
• Resume.

Optional Documents

• Proof of Veteran Status.

Special Instructions to Applicants

Please contact [email protected] for any recruiting related questions. All application materials must be uploaded to the University of Arkansas System Career Site here . Please do not send to listed recruitment contact.

Pre-employment Screening Requirements

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

• Feeling
• Hearing
• Manipulate items with fingers, including keyboarding
• Repetitive Motion
• Sitting
• Talking

Frequent Physical Activity

• Grasping
• Lifting
• Standing

Occasional Physical Activity

• Crouching
• Kneeling
• Reaching
• Walking

Benefits Eligible

Yes