Utilization Management Reviewer/UKHC

Job description

This position works as a member of the multidisciplinary team with social workers, patient care facilitators, financial counselors, and ancillary staff to actively manage
and coordinate those functions associated with third party payer certification, appropriate utilization of health services, and some aspects of discharge planning.

Job Title
Utilization Management Reviewer/UKHC

Requisition Number

Working Title
Utilization Review Nurse

Department Name
H4006:Utilization Review

Work Location
Lexington, KY

Grade Level

Salary Range

Type of Position

Position Time Status

Required Education


Click here for more information about equivalencies:

Required Related Experience

5 yrs

Required License/ Registration/Certification

Licensed Nurse

Physical Requirements

The physical conditions of this position include: occasionally lifting, pushing, and/or
pulling objects up to 50lbs; occasionally standing or walking with objects up to 25lbs;
regularly sitting at a computer workstation for extended periods of time with repetitive
motions (such as typing); regularly working in confined spaces; and occasional
exposure to radiation and combative people; occasional ( job-related travel.


Day shift Monday through Friday


The ideal candidate will possess strong interpersonal, leadership, organizational, and
written/verbal communication skills. General knowledge of criteria for accessing
appropriate utilization of resources in the hospital is necessary. Exceptional planning
and organizational skill. Effective written and verbal communication skills. General
knowledge of criteria utilized by third party payers for admission and continued stay
authorizations is necessary. General knowledge of Medicare, Medicaid, and third
party payer reimbursement issues is necessary.

Does this position have supervisory responsibilities?

Preferred Education/Experience

ADN with 5 years direct patient care experience.

Deadline to Apply

University Community of Inclusion

The University of Kentucky is committed to a diverse and inclusive workforce by ensuring all our students, faculty, and staff work in an environment of openness and acceptance. We strive to foster a community where people of all backgrounds, identities, and perspectives can feel secure and welcome. We also value the well-being of each of our employees and are dedicated to creating a healthy place to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors the University of Kentucky is a Tobacco & Drug Free campus.

As an Equal Opportunity Employer, we strongly encourage veterans, individuals with disabilities, women, and all minorities to consider our employment opportunities.

Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Posting Specific Questions

Required fields are indicated with an asterisk (*).

  1. * Do you have a current Kentucky Registered Nurses license or are you eligible to obtain one by date of hire?
    • Yes
    • No
  2. * Please indicate your years of paid work experience in utilization management.
    • None
    • More than 0, through 1 year
    • More than 1 year, through 3 years
    • More than 3 years, through 5 years
    • More than 5 years
  3. * Do you have knowledge of Medicare guidelines?
    • Yes
    • No
  4. * Do you have experience in working with the Medicare denial process?
    • Yes
    • No
  5. * University of Kentucky HealthCare recognizes a set of values that guide us in our daily interactions. By applying for a position within UK Healthcare, you are indicating your commitment and expressing your agreement to our five values. These values are diversity, innovation, respect, compassion, and teamwork. Please choose one of the UK Healthcare values and give a specific example when you exhibited this quality in your professional experience.

    (Open Ended Question)

  6. * Where did you first see this position advertised other than on UK's online employment system?
    • InsideHigherEd.com
    • HigherEdJobs.com
    • Diverseeducation.com (Diverse Issues in Higher Education)
    • HERCjobs.org (Higher Education Recruitment Consortium)
    • InsightIntoDiversity.com
    • Latinosinhighered.com
    • HospitalCareers.com
    • Indeed.com
    • LinkedIn.com
    • Institute for Diversity in Health Management
    • A Colleague, Friend and/or Family Member
    • None of the Above

Applicant Documents

Required Documents
    Optional Documents
    1. Resume
    2. Cover Letter





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    Job No:
    Posted: 7/13/2018
    Application Due: 7/20/2018
    Work Type: