Utilization Review Nurse
Are you a skilled and experienced Registered Nurse (RN)? Join our team and utilize your expertise to ensure cost-effective quality care.Apply today and make a difference in healthcare delivery!
Join the State of Connecticut, Department of Mental Health and Addiction Services (DMHAS) as a Utilization Review Nurse! In this role, you will review clinical documentation, ensure compliance with Joint Commission and CMS standards, and collaborate with provider teams to support reimbursement, accurate documentation, and effective discharge planning. Bring your skills and compassion to a team dedicated to making a difference in mental health care–explore the details below and take the next step in your meaningful career!
POSITION HIGHLIGHTS:
- FACILITY: Connecticut Mental Health Center (CMHC)
- LOCATION: Administration Department
- ADDRESS: New Haven, CT
- SCHEDULE: Full-time, 40 hours per week, Monday through Friday, First Shift, 8:30 AM - 5:00 PM
- POSITION NUMBER: 102342
New! We’re excited that Connecticut has joined the Nurse Licensure Compact effective October 1, 2025. Visit Nurse Licensure Compact for more details.
WHAT'S IN IT FOR YOU:
- Visit our new State Employee Benefits Overview page
- Professional growth and development opportunities
- A health work/life balance
AS A UTILIZATION REVIEW NURSE, YOU WILL:
- Communicate with patients regarding their entitlements (Medicare/Medicaid, private insurance) and ensure all relevant paperwork is signed
- Collaborate with the Department of Administrative Services (DAS) billing team to ensure accurate reimbursement for inpatient stays
- Monitor length of stay and coordinate with treatment teams on discharge planning
- Conduct ongoing audits and tracers of inpatient documentation to support compliance with Joint Commission and CMS Medicare/Medicaid standards and regulations
- Participate in treatment team meetings and provide feedback on level of care, discharge planning, and related matters
OUR MISSION:
DMHAS is a health care agency whose mission is to promote the overall health and wellness of persons with behavioral health needs through an integrated network of holistic, comprehensive, effective and efficient services and supports that foster dignity, respect and self-sufficiency in those we serve.
ABOUT CMHC:
CMHC is an urban community mental health center with an exceptional 50-year tradition of serving individuals with serious mental illness and/or addiction. Founded in 1966, CMHC is a partnership between DHMAS and the Yale Department of Psychiatry. CMHC is nationally recognized for its scientific research into the causes and treatment of mental illness and addiction. The Abraham Ribicoff Research Facilities include multiple research programs in a variety of areas. CMHC is also a major training site for individuals pursuing careers in mental health fields including psychiatry, psychology, social work, nursing and pastoral care.
Please note:
- A comprehensive medical examination, including a drug screening, will be required of all applicants upon a conditional offer of employment.
- All state employees must adhere to Connecticut’s Policy for a Drug Free Workplace.