Appeals and Denials RN

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Closing Date: 06/30/2025 Type of Position: Clinical Staff - Nursing Job Type: Regular Work Shift: Day Shift (United States of America) Sponsorship Available: No Institution Name: University of Arkansas for Medical Sciences 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 $50,000 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 the Apply 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 orientation, or pregnancy. Questions or concerns about the application of Title IX, which prohibits discrimination on the basis of sex, may be sent to the University’s 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 [email protected]. Department: ICE | CORE PA Cancer Medical Authorization Department's Website: Summary of Job Duties: The Appeals and Denials Nurse is responsible for the efficient and accurate review of medication authorization requests to ensure compliance with national standards. This role involves evaluating requests, applying clinical expertise to support high-quality patient care, preparing and maintaining documentation, and conducting audits of patient records. The nurse will also assist management with various tasks as needed, contributing to the overall effectiveness of the medication authorization process. Qualifications: Minimum Qualifications: Bachelor’s Degree, Associate’s Degree, or Diploma RN, with Major: Registered Nurse. Minimum of 1 year of RN experience Valid Registered Nursing License Current BLS Preferred Qualifications: BSN Minimum of 3 years of RN experience CCM, OCN, or other oncology related national certification. Experience in Prior Authorizations and Billing Oncology Experience Appeals and Denials Experience Additional Information: Responsibilities: The Registered Nurse III will promote wellness; improve outcomes, and self-care within a defined population of patients. The RN III will provide patients who have chronic conditions the support, education, and assistance in the prevention and/or maintenance of their disease and/or health and wellness state. Will work with the individual patient, their families, and providers of care to develop and implement individual health plans and provide support to the patient in self-management. Coordinate care and/or follow-up for patients who receive care in outpatient facilities. Coordination of prescription refill requests and patient education coordination in collaboration with physician staff. Commitment to patient outcomes results in high levels of performance despite workload changes. Salary Information: Commensurate with education and experience. Required Documents to Apply: License or Certificate (see special instructions for submission instructions), List of three Professional References (name, email, business title), Resume Optional Documents: Proof of Veteran Status Special Instructions to Applicants: Recruitment Contact Information: Please contact [email protected] for any recruiting related questions. All application materials must be uploaded to the University of Arkansas System Career Site https://uasys.wd5.myworkdayjobs.com/UASYS Please do not send to listed recruitment contact. Pre-employment Screening Requirements: Annual TB Screening, Criminal Background Check 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: Feeling, Hearing, Manipulate items with fingers, including keyboarding, Repetitive Motion, Sitting, Talking Frequent Physical Activity: Grasping, Reaching, Standing, Walking Occasional Physical Activity: Crouching, Kneeling, Lifting, Pulling, Pushing, Stooping Benefits Eligible: Yes The University of Arkansas System is a comprehensive, publicly-supported higher education institution composed of 18 unique campuses, divisions and administrative units that share the singular goal of serving Arkansas residents and others by developing and sharing knowledge to impact an ever-changing world. The UA System provides access to academic and professional education, and develops intellectual growth and cultural awareness in its students, staff and faculty. The system further promotes an atmosphere of excellence that honors the heritage and diversity of our state and nation. It provides students, researchers and professionals with tools to promote responsible stewardship of human, natural and financial resources in Arkansas and around the globe, and with workforce-relevant knowledge to enhance economic development efforts that improve the overall quality of life and societal well-being. Universities University of Arkansas, Fayetteville University of Arkansas at Little Rock University of Arkansas for Medical Sciences University of Arkansas at Monticello University of Arkansas at Pine Bluff University of Arkansas at Fort Smith The University of Arkansas System eVersity Two-Year Colleges Phillips Community College of the University of Arkansas University of Arkansas Community College at Hope-Texarkana University of Arkansas Community College at Batesville Cossatot Community College at the University of Arkansas University of Arkansas Community College at Morrilton University of Arkansas Community College at Rich Mountain University of Arkansas Pulaski Technical College Other Units University of Arkansas System Division of Agriculture Arkansas Archaeological Survey Criminal Justice Institute Arkansas School for Math, Sciences, and the Arts University of Arkansas Clinton School of Public Service Arkansas Research and Education Optical Network (ARE-ON) Apply Job!