Utilization Management Reviewer/UKHC

Posting DetailsJob Title Utilization Management Reviewer/UKHC Requisition Number RE54421 Working Title Utilization Management Reviewer Department Name H4025:Revenue Integrity Work Location Lexington, KY Grade Level 11 Salary Range $54,080-95,056/year Type of Position Staff Position Time Status Full-Time Required EducationADNClick here for more information about equivalencies: https://hr.uky.edu/employment/working-uk/equivalencies Required Related Experience5 yrsRequired License/Registration/CertificationRegistered Nurse (RN)Physical RequirementsThe physical conditions of this position include: Occasional walking with objects 10lbs. 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.ShiftDay shift including weekends and holidaysHybridJob SummaryThis 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.This is a Hybrid positionIEBC (Internal Employee Being Considered)Skills / Knowledge / AbilitiesThe 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? No Preferred Education/ExperienceADN with 5 years direct patient care experience.Deadline to Apply 05/24/2026 Our University CommunityWe value the well-being of each of our employees and are dedicated to creating a healthy place for everyone 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.The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status.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.