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Utilization Review Nurse Coordinator (40 Hour)

Office/On-site

Recruitment # 250924-5613FP-001

Location East Hartford, CT

Date Opened 9/30/2025 12:00:00 AM

Salary $86,261* - $116,571/year (*New State Employees start at minimum salary range)

Job Type Open to the Public

Close Date 10/6/2025 11:59:00 PM

Go Back Apply View Benefits (https://www.jobapscloud.com/CT/jobs/?b=Benefits)

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+ Introduction

Are you a Registered Nurse (RN) interested in a career where you can make a difference for individuals and families?

The State of Connecticut (https://portal.ct.gov/) , Department of Developmental Services (DDS (https://portal.ct.gov/dds?language=en\_US) ) – North Region (https://portal.ct.gov/dds/searchable-archive/northregion/north-region/welcome-to-the-north-region?language=en\_US) - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=) (Regulatory) position, located at North Region Regional Directors Office, East Hartford, CT.

POSITION HIGHLIGHTS

+ Full Time, 80-HR/Biweekly

+ Schedule: Monday – Friday: 8:00am – 4:30pm

+ Regular Days Off: Saturday, Sunday

+ Location: North Region Regional Directors Office, East Hartford

+ Work schedule flexibility is required to meet the demands of the position

Please Note:

+ Incumbents will be required to travel.

WHAT WE CAN OFFER YOU

+ Visit our State Employee Benefits Overview (https://www.jobapscloud.com/CT/jobs/?b=Benefits) page!

+ Professional growth and development opportunities.

+ A healthy work/life balance (https://www.youtube.com/watch?v=y6n9M1Qd5fo) to all employees.

+ The State of Connecticut is an eligible Public Service Loan Forgiveness employer, meaning you may be eligible to have qualifying student loans forgiven after 10 years of service. Click here (https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service) for more information.

New! We’re excited that Connecticut has joined the Nurse Licensure Compact effective October 1, 2025. Visit Nurse Licensure Compact for more details.

DISCOVER THE OPPORTUNITY TO

+ Engage in a rewarding career

+ Make a difference in the public sector

+ Work together in a collaborative team environment

START WITH US. STAY WITH US. GROW WITH US.

Selection Plan

FOR THOSE WHO HOLD AN RN LICENSE IN A STATE OTHER THAN CONNECTICUT AND WISH TO APPLY FOR A CONNECTICUT LICENSE, PLEASE:

+ Review the eligibility and documentation requirements (https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/Registered-Nurse/RN-Licensure-by-Endorsement) for CT license by endorsement of an out-of-state license;

+ Complete a CT DPH online application (https://www.elicense.ct.gov/) 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:

+ Check out our Applicant Tips on How to Apply! Need more resources? Visit our Applicant Reference Library (https://portal.ct.gov/das/home/services-for-state-employees/statewide-human-resources/applicant-reference-library?language=en\_US) for additional support throughout the recruitment process.

+ If you require an accommodation to participate fully and fairly under the provisions of the Americans with Disabilities Act (ADA), please contact Edward Magnano, EEO Manager at (860) 418-6148 or [email protected].

BEFORE YOU APPLY:

+ Meet Minimum Qualifications: Ensure you meet the Minimum Qualifications listed on the job opening by the job closing date. You must specify your qualifications on your application. The minimum experience and training requirements listed must be met by the close date on the job opening, unless otherwise specified.

+ Educational Credits: List your earned credits and degrees from accredited institutions accurately on your application. To receive educational credits towards qualification, the institution must be accredited. If the institution of higher learning is located outside of the U.S., you are responsible for providing documentation from a recognized USA accrediting service which specializes in determining foreign education equivalencies to the contact listed below by the closing date listed on the job posting.

+ Resume Policy: Per Public Act 21-69 (https://www.cga.ct.gov/2021/act/pa/pdf/2021PA-00069-R00SB-00056-PA.pdf) , resumes are not accepted during the initial application process. As the recruitment process progresses, candidates may be required to submit additional documentation to support their qualification(s) for this position. This documentation may include: a cover letter, resume, transcripts, diplomas, performance reviews, attendance records, supervisory references, licensure, etc., at the request and discretion of the hiring agency.

+ Preferred Shift/Location: Select all location(s) and shift(s) you are willing to work on your application. Failure to do so may result in not being considered for vacancies in that specific location or shift.

+ Timely Submission: All application materials must be received by the job posting deadline. You will be unable to make revisions once you officially submit your application to the State. Late submissions are rarely accepted, with exceptions only for documented events that incapacitate individuals during the entire duration of the job posting. Request exceptions by emailing [email protected].

+ Salary Calculations: For current state employees, salary calculations are not necessarily comparable from one of the three branches of state government (i.e., Executive, Legislative, Judicial) to the other.

+ Note: The only way to apply to this posting is via the ‘Apply’ or ‘Apply Online’ buttons on the official State of Connecticut Online Employment Center job posting.

AFTER YOU APPLY:

+ Referral Questions: This posting may require completion of additional Referral Questions (RQs), which must be completed by the questionnaire’s expiration date. If requested, RQs can be accessed via an email sent to you after the job close date or by visiting your JobAps Personal Status Board (Certification Questionnaires section).

+ Prepare For An Interview: Interviews are limited to those whose experience and training are most aligned with the role. To prepare, review this helpful Interview Preparation Guide to make the best impression!

+ Stay connected! Log in daily to your JobAps Personal Status Board to track your status and check email (including spam/junk folders) for updates and tasks.

+ The immediate vacancy is listed above, however, applications to this recruitment may be used for future vacancies in this job class.

+ Note: This position will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules. Candidates who are offered and accept a position with the State of Connecticut are bound by the State Code of Ethics for Public Officials and State employees, available at www.ct.gov/ethics.

QUESTIONS? WE’RE HERE TO HELP:

Due to high volume, we are unable to confirm receipt or provide status updates directly. For recruitment updates, please check your Personal Status Board and review our Frequently Asked Questions. If you have additional questions about the recruitment process, reach out to Pamela Rochette at [email protected] .

Join the State of Connecticut and take your next career step with confidence!

PURPOSE OF JOB CLASS (NATURE OF WORK)

In a state agency this class is accountable for coordinating a utilization review program which promotes effective cost recovery, quality of care and/or compliance with relevant federal and state laws, regulations and standards.

In the Department of Developmental Services this class is accountable for performing investigations of abuse, neglect and death in individuals with an intellectual disability including individuals under the care of the Department of Developmental Services.

EXAMPLES OF DUTIES

WORKING LEAD (REGULATORY):

+ Coordinates workflow and determines priorities to assure highest quality of care with efficient utilization of available services;

+ Schedules, assigns, oversees and reviews work;

+ Establishes and maintains program protocols and procedures;

+ Provides staff training and assistance;

+ Conducts or assists in conducting performance evaluations;

+ Acts as liaison with other operating units, agencies and outside officials regarding program policies and procedures;

+ Prepares reports and correspondence;

+ Assesses, evaluates and monitors documentation of all hospital disciplines when performing case reviews;

+ Attends professional workshops, seminars and in-service training;

+ May supervise Utilization Review Nurses and other staff engaged in review of medical records of individuals in state health care facilities for purposes of maximizing reimbursement revenue via Medicare Part B programs;

+ May review medical records and compile documents for case presentations;

+ May provide pre-certification for and coordination of inmates admitted to and discharged from acute care facilities;

+ May lead an inspection team in IPR/UR and licensing review functions;

+ May conduct entrance and exit interviews of care providers;

+ May supervise and participate in hospital Medicare and Medicaid reimbursement programs including preparation of appeals on behalf of a facility relative to intermediate denials;

+ May testify in court;

+ May coordinate review and audit of occupational injury and/or disease disability cases for purpose of determining medical management, cost containment, peer review and rehabilitation;

+ May notify acute care hospitals of scheduled utilization review including conducting second level review of cases and case referral to a physician consultant for final disposition;

+ Performs related duties as required.

KNOWLEDGE, SKILL AND ABILITY

+ Considerable knowledge of

+ principles, practices and current trends of nursing;

+ standards of medical care

+ Considerable

+ interpersonal skills;

+ oral and written communication skills;

+ Considerable ability to analyze individual profiles and progress charts;

+ Supervisory ability.

REGULATORY:

+ Considerable knowledge of

+ and ability to apply relevant state and federal laws, statutes and regulations;

+ regulations and standards pertaining to utilization review;

+ care and service delivery to injured workers.

INVESTIGATORY:

+ Considerable knowledge of

+ statutes, policies and procedures governing the care and treatment of individuals with an intellectual disability;

+ problems and needs of individuals with an intellectual disability;

+ various types of residential placement facilities;

+ Knowledge of investigatory methods and techniques;

+ Considerable

+ interviewing skills;

+ skills in the preparation of extensive written reports;

+ Ability to research and analyze data.

DEPARTMENT OF VETERANS AFFAIRS:

+ Knowledge of Minimum Data Set process in a long-term care setting and coordination of an interdisciplinary team;

+ Ability to utilize computer software.

MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE

Five (5) years of experience as a Registered Nurse.

MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE

REGULATORY: Two (2) years of the General Experience must have been in the assessment of the quality and propriety of health care services as required by Joint Commission on Accreditation of Healthcare Organizations (JCAH) and/or Medicare and Medicaid standards and regulations at the level of Utilization Review Nurse.

INVESTIGATORY: Two (2) years of the General Experience must have been working with persons with behavioral health disabilities or an intellectual disability.

DEPARTMENT OF VETERANS AFFAIRS: Two (2) years of the General Experience must have been in the review and assessment of individuals in a long-term care setting.

MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED

A Bachelor's degree in nursing may be substituted for one (1) year of the General Experience.

PREFERRED QUALIFICATIONS

+ Experience working with individuals with intellectual and developmental disabilities, assessing their medical and behavioral needs across the life span.

+ Experience with discharge planning from hospitals or Skilled Nursing facilities, to family or own homes.

+ Experience providing nursing oversight regarding the Omnibus Budget Reconciliation Act (OBRA).

+ Experience coordinating with Private Agency Providers, Skilled nursing Facilities.

+ Experience with current Department of Developmental Services Nursing Policies, Procedures, and Regulations and mortality review process.

+ Experience in a supervisory role.

+ Experience auditing charts for quality assurance compliance.

+ Experience using Microsoft applications, including Outlook, Excel, Teams, and Word.

SPECIAL REQUIREMENTS

+ Incumbents in this class must possess and retain a current license as a Registered 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.

Click on a link below to apply for this position:

Fill out the Supplemental Questionnaire and Application NOW using the Internet. Apply Online