Utilization Review Coordinator

This posting has been extended

• SIGN-ON BONUS $10,000 *

for the  successful applicant of this posting.

See "Eligibility for Sign-On Bonus" below in the

Supplemental and Contact Information section for details.

The Julian F. Keith Alcohol & Drug Abuse Treatment Center (JFK - ADATC) in Black Mountain has an excellent opportunity for an Utilization Review Coordinator (Nurse Consultant I).   If you are looking for a meaningful career working as part of a multi-disciplinary team that impacts lives, please consider this opportunity at JFK - ADATC in Black Mountain, NC.  

The primary responsibility of the Utilization Review Coordinator (Nurse Consultant I) is to ensure that clinically appropriate care, discharge and cost-effective utilization of services are maintained across the treatment continuum at the facility.    Additional duties include:

• Provides ongoing clinical review of patients served at the facility - from admission through discharge (in conjunction with the Utilization Review Committee, the Quality Assurance Coordinator, Director of Nursing, Clinical Program Director, CMO/Clinical Director, and CEO/Facility Director).

• Leads team in assuring that admissions, continued stays, discharges, and appeals related to service provisions are reviewed and responded to in a timely and clinically sound manner in accordance with written policies of the governing body and the facility's Utilization Management Plan.

• Follows policies and protocols defined by third party payers for patients entitled to benefits under the Medicare and Medicaid programs; and handles clinical consultations with insurance carriers, managed care entities, and Quality Improvement Organizations for certification and re-certification of services.

• Familiar with all aspects of beneficiary rights, quality improvement efforts, and payment and reimbursement issues.

• Facilitates educational and training activities with clinical staff related to quality improvement efforts, risk management and areas related to patient safety and staff responsiveness.

This position will primarily work 8-hour days; Monday to Friday.

Per G.S. 126-5 (c1) (37), this position is Exempt from all provisions of NC General Statute Chapter 126 (State Human Resources Act) with the exception of Articles 6 and 7.

About the facility:

JFK is a 68-bed inpatient treatment facility designed to meet the needs of adults with substance use disorders from the 44  westernmost counties in North Carolina.  The facility treats individuals with substance abuse and psychiatric diagnoses.  JFK is accredited by the Joint Commission on Accreditation of Healthcare Organizations as a Behavioral Health facility and certified by the Centers for Medicare and Medicaid Services as an inpatient psychiatric hospital

About NC Department of Health and Human Services:

The North Carolina Department of Health and Human Services (DHHS) serves the needs of the most vulnerable of North Carolinians and to accomplish this, we hire only the most dedicated and caring individuals.  Finding qualified clinical professionals to treat and care for our clients is a continual challenge as demand for services grows and the availability of providers struggles to keep pace.  We are seeking a motivated individual who is up for this challenge and is dedicated to our mission of providing North Carolinians with the very best in clinical care.

Compensation & Benefits:

The State of North Carolina offers excellent comprehensive benefits.  Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis). Employees also receive paid vacation, sick, and community service leave.  In addition, paid parental leave is available to eligible employees.

Visit our website for additional information on State Benefits for employees.

JFK-ADATC is an approved loan repayment facility with HRSA Nursing Corps and the STAR Program where employees can apply for programs that will repay part or all of your outstanding student loan debt!

This position is designated Mandatory and 

must report or stay over during adverse weather events.

Candidates are qualified based upon the information submitted on the state job online application.  Any information omitted from the application but included in an attachment, will not be considered as qualifying experience.  PLEASE INCLUDE ALL Knowledge, Skills and Abilities IN THE BODY OF THE APPLICANTION, resumes are not acceptable.

Work history and education (as applicable for the position) must be included on the application.  "See Resume or See Attachment" will not be accepted, nor is a text or attached resume accepted in lieu of a completed application.  Please complete your application in full.

Qualified applicants must document on the application that they possess ALL of the following:

• Considerable knowledge and skill in application of professional nursing theory, techniques and practices.

•  Demonstrated knowledge of beneficiary requirements for commercial coverage and of Medicaid and Medicare standards.

• Demonstrated ability to gather, compile, and analyze data related to quality patient care.

• Ability to approach job functions with opportunities to assist patients and improve delivery systems.

• Ability to communicate with all levels of staff and third party payors.

For tips on how to complete this online application, please visit https://oshr.nc.gov/work-for-nc/how-do-i-get-job.      Some state job postings say you can qualify by an "equivalent combination of education and experience." If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both.

See https://oshr.nc.gov/experience-guide for details   

Minimum Education and Experience:

• Licensed to practice as a Registered Nurse in the State of North Carolina and

• One year of experience in Utilization Review.

Management Preferences:

•  A strong nursing educational background is preferred with a focus and understanding of the particular needs of patients with co-occurring substance use and mental health disorders.

For tips on how to complete this online application, please visit https://oshr.nc.gov/work-for-nc/how-do-i-get-job.  

Eligibility for Sign-on Bonus

Qualified applicants must be selected from the candidate pool of this posting and meet the State policy following requirements:

A newly hired permanent full time or permanent part-time employee who works 30 to 40 hours per week is eligible for a sign-on bonus (this will be prorated for employees working less than 40 hours per week).

An employee is not eligible for a sign-on bonus if: 

• the employee has held a position in North Carolina State government, including the judicial system, or the University of North Carolina system within the last 12 months (the employee shall remain ineligible for 12 months from the separation date);
• the employee has previously received a sign-on bonus from any State agency;
• or DHHS has paid any contract placement or recruitment fees.

This Sign-on Bonus is contingent upon budget and final eligibility determination as of the effective date of hire. Additional information regarding the Sign-on Policy can be found here.

• All Division of State Operated Healthcare Facilities are a tobacco free environment.  The use of tobacco products of any kind including vapor products are prohibited from our campus.

• All employees are required to adhere to the facility's Vaccination Policy.

• All positions in the Division of State Operated Healthcare Facilities shall be subject to pre-employment drug testing and criminal record background checks.

Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone.  To check the status of your application, please log in to your account.  Communication with applicants regarding the status of their application will be via email only.  You will either receive a call to schedule an interview or an email notifying you when the job has been filled.

For technical issues with your applications, please call the NeoGov Help Line at 855-524-5627. If there are any questions about this posting other than your application status, please contact Human Resources at 828-257-6238.