Medicaid Review Nurse - Central Office (son)

Job Description

The work we do matters!

Hiring Agency:

Correctional Services - Agency 46

Location:

Lincoln, NE

Hiring Rate:

$25.061

Job Posting:

JR2024-00009078 Medicaid Review Nurse - Central Office (Open)

Applications No Longer Accepted On (If no date is displayed, job is posted as open until closed):

09-11-2024

Job Description:

The Nebraska Department of Correctional Services (NDCS) employs nearly 2,300 team members operating nine institutions, which house approximately 5,200 inmates, statewide. The department's focus includes inmate programming and education, physical and behavioral health care, re-entry services, and community programs, and is accredited by the American Correctional Association (ACA). Candidates will model the NDCS values of integrity, respect, compassion, growth, and excellence as we accomplish our mission, "Keep people safe." Information about the Department can be found at: www.corrections.nebraska.gov. For more information about this position, call 402-471-2654. For Americans with Disabilities Act (ADA) accommodations, please contact Megan Jones at megan.jones@nebraska.gov.

DUTIES
Manage and process all Medicaid applications for all NDCS incarcerated individuals: distribute applications, review all returned applications for accuracy and completeness; review application to determine if meets Medicaid eligibility requirements; obtain additional documentation required for eligibility; submit application to HHS Medicaid division; maintain records of the applications; track status of all Medicaid applications. Perform quality control duties involving medical services provided to the incarcerated population by outside and internal providers including utilization review. Send current contractor who processes NDCS’ medical claims from outside providers (BCBS) listing of all Medicaid approved incarcerated individuals. Serve as contact for hospitals, outside providers and HHS Medicaid on questions, issues, etc. involving NDCS’ Medicaid project. Assists Utilization Review Nurse with other utilization duties, CQI, and the peer review process.

 

Requirements / Qualifications

Minimum Qualifications: A current license to practice as a Licensed Practical Nurse in Nebraska or authority based on the Nurse Licensure Compact to practice as a Licensed Practical Nurse in Nebraska is required. 

Preferred Qualifications: Experience with Interqual. Experience with the utilization review process. Experience with Microsoft Office, particularly Excel. Experience performing audits.

Other: Will complete four to eight weeks of on the job training. Must submit to background security check. Applicants accepting a job offer must pass the pre-employment medical examination and a drug test. Once at the Staff Training Academy, must successfully complete the fully paid Nebraska Department of Correctional Services' Pre-service Training Program.

 

 

Benefits

We offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life. Your paycheck is just part of your total compensation.

Check out all that the State of Nebraska has to offer! Benefit eligibility may vary by position, agency and employment status. For more information on benefits, please visit: https://statejobs.nebraska.gov/index.html#benefits

Equal Opportunity Statement

The State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.

Current employees of the State of Nebraska should NOT apply on this external career. Instead go to Workday and access the Jobs Hub - Internal Apply app from your home landing page.