PEHP Health & Benefits is a division of the Utah Retirement Systems that proudly serves Utah’s public employees through high quality and competitively priced medical, dental, life, and long-term disability insurance plans on a self-funded basis. As a government entity, we embrace both a public mission and a commitment to creating customer value, excelling in the market, and improving healthcare. We offer a competitive salary with generous benefits, personal development in a positive team environment, and excellent work-life balance.
This job may be filled at either of the levels listed below.
Nurse I- Min: $26.52/hr. Max: $33.14/hr.
Nurse II- Min: $31.74/hr. Max: $40.47/hr.
Nurse III- Min: $72,970.92/yr. Max: $93,033.28/yr.
POSITION SUMMARY
This is an entry level nursing position for nurses who can demonstrate the ability to work efficiently under the direct supervision of the Nursing Supervisor, correctly applying PEHP policies and principles, following through on assignments, and communicating professionally and effectively with providers and members. The Nurse must always demonstrate judgment, high integrity, and personal values consistent with the company’s standards. The position involves identifying and coordinating the healthcare needs of PEHP members within a variety of programs and departments with the goal of providing high-quality, cost-effective outcomes.
ESSENTIAL JOB FUNCTIONS AND DUTIES
NURSE I
Education and Experience
Currently licensed and in good standing as a Registered Nurse (RN). New graduates may apply.
Currently licensed and in good standing as a Licensed Practical Nurse (LPN) with a minimum of three (3) years of medical experience in a broad spectrum of direct patient care and utilization review; or an equivalent combination of education and experience.
NURSE II
Education and Experience
Currently licensed and in good standing as a Registered Nurse (RN) and a minimum of three (3) years OR currently licensed and in good standing as a Practical Nurse (LPN) with a minimum of nine (9) years of combined experience in a broad spectrum of nursing, utilization review, and/or medical case management.
CMCN or CCM certificate preferred.
NURSE III
Education and Experience
Currently licensed (or license eligible) as a Registered Nurse in the State of Utah, in good standing, with at least three (3) years of case management experience or five (5) years of clinical experience; or an equivalent combination of education and experience.
A bachelor’s degree in nursing and experience working in case management or for a healthcare payor are preferred.
Certification in Managed Care Nursing (CMCN) or Certified Case Manager (CCM) is preferred.
Certified Professional Coder (CPC) is preferred.
Knowledge of HealthEdge HealthRules Payor and HealthRules Care Manager is preferred.
Knowledge, Skills, and Abilities
This list contains knowledge, skills, and abilities that are typically associated with the job. It is not all-inclusive and may vary from position to position:
Required technical skills include the working knowledge and ability of:
Required mathematical skills include working knowledge of:
Must possess working knowledge of:
Must possess excellent communication skills:
Must have the ability to:
The incumbent must always demonstrate judgment, high integrity, and personal values consistent with the values of URS.
Work Environment
Incumbent performs in a typical office setting with appropriate climate controls. Tasks require a variety of physical activities which do not generally involve muscular strain, but do require activities related to walking, standing, stooping, sitting, reaching, talking, hearing and seeing. Common eye, hand, finger dexterity required to perform essential functions.
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