RN Authorizations & Coordination
Little Rock, AR - USA
Job Summary
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The University of Arkansas for Medical Sciences (UAMS) has a unique combination of education research and clinical programs that encourages and supports teamwork and diversity. We champion being a collaborative health care organization focused on improving patient care and the lives of Arkansans.
UAMS offers amazing benefits and perks (available for benefits eligible positions only):
- Health: Medical Dental and Vision plans available for qualifying staff and family
- Holiday Vacation and Sick Leave
- Education discount for staff and dependents (undergraduate only)
- Retirement: Up to 10% matched contribution from UAMS
- Basic Life Insurance up to $50000
- Career Training and Educational Opportunities
- Merchant Discounts
- Concierge prescription delivery on the main campus when using UAMS pharmacy
Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening. To apply for the position please click theApply link/button.
The University of Arkansas is an equal opportunity institution. The University does not discriminate in its education programs or activities (including in admission and employment) on the basis of any category or status protected by law including age race color national origin disability religion protected veteran status military service genetic information sex sexual preference or pregnancy. Questions or concerns about the application of Title IX which prohibits discrimination on the basis of sex may be sent to the Universitys Title IX Coordinator and to the U.S. Department of Education Office for Civil Rights.Persons must have proof of legal authority to work in the United States on the first day of employment.
All application information is subject to public disclosure under the Arkansas Freedom of Information Act.
For general application assistance or if you have questions about a job posting please contact Human Resources at .
Department:
Departments Website:
Summary of Job Duties:
Qualifications:
Minimum Qualifications:
- Bachelors Degree Associates Degree or Diploma RN with Major: Registered Nurse.
- Minimum of 3 years of RN experience
- Valid Arkansas Registered Nursing License
- Current BLS
Preferred Qualifications:
- Case Management experience 5 years or more
- CCM or other Oncology related National Nursing Certification
- Oncology Stem Cell Transplant
This position WILL have patient contact or other duties that will require:
- Annual TB (UAMS Policy 4.5.18)
- Background Check (UAMS & Medical Center Policy HR.3.02)
- Drug Test (UAMS Policy 3.1.14)
Nothing in this position description restricts managements right to assign or reassign duties and responsibilities to this position at any time. Changes in duty and/or schedule can be made based on business needs with a two-week notice to the employee.
Additional Information:
Job Requirements:
- Coordinates outside new patient referrals.
- Ensures that a verification of benefits is ran on every transplant candidate.
- Reviews verification of benefits and educates the patient on transplant coverage.
- Works with Insurance Case Manager to open evaluation for stem cell transplant case.
- Reviews outside records noting recommendations & works to obtain missing information or testing that is required for pre-transplant evaluation.
- Participates in patient financial education of transplant financial resources and case manager role.
- Refers patient to AR Medicaid enrollment or other payer sources.
- Reviews charts to ensure that all payer required pre-testing is complete.
- Gathers all clinical work-up and submit case for transplant authorization.
- Notifies the MD Clinic RN TC and BMT global notification email distribution group of the approval and if it is global or not
- Opens transplant cases with insurance companies and maintain contact throughout the process and up to one-year post transplant. Dependent upon insurance requirements.
- Once approval is received follows patient and provide clinical updates every month or as required by insurance until the patient is 100 days post-transplant.
- Follows CMS (Medicare) guidelines and audit patient charts to ensure that our transplants are within Medicare Guidelines.
- Completes and has physician sign Internal Medicare Guidelines Form when for Medicare patients.
- Keeps track of global dates inform the transplant team of global dates.
- Appeals insurance denials with clinical documentation letters of medical necessity if required.
- Communicates with patients throughout the transplant process keeping them informed of where they are in the approval process.
- Reports quarterly to the Cancer Institute Stem Cell Transplant QI Meeting: monthly number of referrals approvals consults.
- Participate in meetings regarding reimbursement contract negotiations billing etc.
- Act as a liaison between inpatient case management and social work and outpatient social worker.
- Maintain open communication on all transplant patients with insurance case managers. Notifying them if patient is referred for a 2nd opinion or to OSH for transplant or that patient is no longer a candidate for transplant.
- Reviews National Marrow Donor Program invoices. Determine what donor charges are covered by an NMDP grant. Notify Donor coordinator of when appropriate to ask for NMDP grants. Submit paperwork for grants and keep accurate record of all grants. Works with billing department to insure all grant moneys are appropriate and if not work with them to insure refunds are issued.
- Follows SOP Guidelines.
- Stays current with trends in the industry by referencing of professional literature or publications including Web-based information. Must stay up to date with frequent insurance company changes and help providers and patients understand when the changes affect their care/treatment plan.
- Perform other duties as needed.
PHYSICAL REQUIREMENTS
Stand: Frequently
Sit: Frequently
Walk: Occasionally
Bend crawl crouch kneel stoop or reach overhead: Frequently
Lift and carry weight: 25 lbs
Push and pull weight: 25 lbs
Use hands to touch handle or feel: Frequently
Talk: Continuously
Hear: Continuously
Taste or smell: Occasionally
Read concentrate think analytically: Continuously
Physical Environment: Inside Medical Facility Environment
Salary Information:
Required Documents to Apply:
Optional Documents:
Special Instructions to Applicants:
Recruitment Contact Information:
Please contact for any recruiting relatedquestions.
All application materials must be uploaded to the University of Arkansas System Career Site
Please do not send to listed recruitment contact.
Pre-employment Screening Requirements:
This position is subject to pre-employment screening (criminal background drug testing and/or education verification). A criminal conviction or arrest pending adjudication alone shall not disqualify an applicant except as provided by law. Any criminal history will be evaluated in relationship to job responsibilities and business necessity. The information obtained in these reports will be used in a confidential non-discriminatory manner consistent with state and federal law.
Constant Physical Activity:
Frequent Physical Activity:
Occasional Physical Activity:
Benefits Eligible:
About Company
UACCB is a two-year, accredited Arkansas community college with on-campus and online classes offering a variety of degrees and technical certificates.