Job Description
Job Description
Introduction
The State of Connecticut , Department of Children and Families (DCF), seeks qualified individuals for a Utilization Review Nurse position.
Are you passionate about making a difference in the lives of children and adolescents? Do you have a proven track record in providing quality assurance and ensuring compliance with healthcare regulations? If so, we have an exciting opportunity for you to join us at the Albert J. Solnit Children's Center – South Campus Psychiatric Residential Treatment Facility (PRTF) in Middletown, CT. In this fully on-site position, you will be part of a team that embraces quality, compliance and creativity as part of ongoing performance improvement.
Position Highlights
- Full-time, 40 hours per week
- First (1st) shift
- 8:00 a.m. - 4:30 p.m.
- Monday - Friday
- Albert J. Solnit Children's Center – South Campus, Middletown, CT
Job Responsibilities
- Conduct utilization reviews to determine the appropriate level of care and length of stay for patients.
- Collaborate with interdisciplinary teams to ensure effective and efficient utilization of resources.
- Develop and implement utilization review protocols and procedures.
- Ensure adherence to state and federal standards and regulations relating to mental health care.
- Provide training and education to staff on utilization review processes.
- Prepare reports, tables, and graphs to analyze data and track performance.
What’s In It For You
Visit our
new State Employee Benefits Overview page!
- 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;
- Professional growth and paid professional development opportunities.
- A healthy work-life balance to all employees.
- State of Connecticut is an eligible Public Service Loan Forgiveness employer, meaning you may be eligible to have qualifying student loan forgiveness after 10 years of service. Click here for more information.
Discover The Opportunity To
- Engage in a rewarding career
- Assist our employees so they can achieve success
- Make a difference in the public sector
- Work together in a collaborative team environment
Selection Plan
For Those Who Hold a Rn License In a State Other Than Connecticut And Wish To Apply For a Connecticut License, Please
- Review the eligibility and documentation requirements for CT license by endorsement of an out-of-state license;
- Complete a CT DPH online application online (expand the ‘Public Health Practitioners’ grouping, select ‘Registered Nurse’ and then ‘Start’;
- 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.
For Assistance In Applying
Please read or watch our Applicant Tips on How to Apply!
Application Process
This position will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules.
For current state employees, salary calculations are not necessarily comparable from branch to branch but it does not impact your state service credit.
In order to comply with Public Act 21-69, the State of Connecticut is no longer asking for resumes during the initial application process.
In order to be considered for this job opening, you must meet the minimum qualifications as listed on the job opening. You must specify your qualifications on your application. The minimum experience and training requirements must be met by the close date, unless otherwise specified.
The immediate vacancy is listed above, however, applications to this recruitment may be used for future vacancies in this job class.
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 ensure that your application is complete. You will be unable to make revisions once you officially submit your application to the state of Connecticut.
Selection Process
This posting may require completion of additional referral questions (RQs) which will be sent to you via email after the closing date. The email notification will include an expiration date by which you must submit (Finish) your responses. Please regularly check your email for notifications. Please check your SPAM and/or Junk folders, as emails could end up there in error.
During the recruitment process, applicants may be required to submit additional documentation supporting their qualification(s) for this position. These documents may include performance reviews, supervisory references, college transcripts, licensure, etc. at the discretion of the agency.
Read through this helpful link to prepare for your interview . Contact Information
Due to the large volume of applications received, we are unable to provide confirmation of receipt or status during the recruitment process.
Should you have any questions pertaining to this recruitment, please contact Elizabeth Pinette at Elizabeth.Pinette@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 in-service training;
- Maintains up to date knowledge of all changes in relevant discipline;
- Monitors personal injuries and medical costs to evaluate need for services billed for appropriate injuries;
- May monitor agency and third party administrator files to oversee contractor handling;
- 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;
- standards of practice of medicine and nursing as well as other health care disciplines;
- regulations and standards pertaining to utilization review;
- care and service delivery to injured workers;
- Skills
- 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 of 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 providing quality assurance specifically, writing reports, creating tables and graphs, analyzing data and performance improvement protocols.
- Experience with Microsoft Excel and data reporting.
- Experience conducting quality audits for compliance to regulations.
- Experience with training and educating staff.
- Experience with State and Federal behavioral health standards and regulations, including, but not limited to: The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS), Department of Public Health (DPH).
Special Requirements
- Incumbents in this class must possess and retain a license as a Registered Professional Nurse in Connecticut.
- 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.
ACKNOWLEDGEMENT
As defined by Sec. 5-196 of the Connecticut General Statutes, a job class is a position or group of positions that share general characteristics and are categorized under a single title for administrative purposes. As such, a job class is not meant to be all-inclusive of every task and/or responsibility.
Job Tags
Full time, For contractors, Immediate start, Flexible hours, Day shift, Monday to Friday,