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REGISTERED NURSE

Date:  Sep 10, 2021
Req ID:  9537
Location: 

Little Rock, AR, US, 72201

Category:  OFC OF MEDICAID INSPECTOR GEN
Anticipated Starting Salary:  63830.00

Position Number: 22100150 
County: Pulaski 
Posting End Date: OPEN UNTIL FILLED

Anticipated Starting Salary: 63830.00 

 

 

OMIG REGISTERED NURSE aka “Nurse Analyst” (NA) reports to the OMIG Nurse Manager in the Office of the Medicaid Inspector General, Dept of Inspector General and works under minimum supervision with extensive latitude for use of initiative and independent judgment. Using advanced nursing knowledge, this position performs utilization review activities, consultative and technical work pertaining to research/development of information related to fraud, abuse, and/or waste cases in the Arkansas Medicaid Program.

 

Position requires:

  • Extensive computer skills (Microsoft Office Suite; Microsoft SharePoint; IBM Cognos) to develop written reports & spreadsheets
  • ICD 10 coding and CPT Coding Books to determine appropriate CPT Codes in use and appropriately documented and paid.
  • Effective communication both oral/written with vendors, state and federal agencies, operating agency/training of staff
  • Occasional travel with overnight stays, ability to drive a state vehicle, and work hours other than 8:00–4:30
  • May require court testimony as a subject matter expert and deliver presentations regarding OMIG
  • Regular performance of other projects, duties as assigned and required to maintain program integrity operations
  • Advanced nursing knowledge to review, analyze and refer suspect provider activity via written reports
  • License to practice as an unrestricted Registered Nurse in the state of Arkansas or current unrestricted RN license in a state recognized by the Arkansas Compact Licensure Agreement. Bachelor's degree in Nursing preferred. Medical Coding Certification preferred. Possibly add Clinical Documentation Improvement (CDI) experience helpful. Case management experience preferred

 

Proficiencies needed:

  • Strong analytical, basic research skills related to the retrieval and organization of high volumes of information
  • Proven ability to work in a deadline-driven environment and multi-task

 

  • Leadership through assistance provided to auditors with policy and audit decisions

 

  • Capacity to build/maintain strong relationships with internal/external personnel
  • Serve as an Executive presence with the State Medicaid Agency and other outside entities as necessary and possess ability to act as primary contact on assignments
  • Capable of comparing data analysis reports, audit reports, and Ad hoc reports and processes for duplication/effectiveness
  • Ability to perform specialized research for advanced consultative and technical work related to fraud, abuse and/or waste cases in the Arkansas Medicaid Program
  • Stay informed and communicate current medical practices, changes in Medicaid Medical Policy and Program

 

Considerable Knowledge/Skill in:

Medicaid program rules, regulations, policies/processes/protocols, claims/database system

Health care laws and regulations; utilization review and control measures

Nursing techniques, medical diagnoses, procedures and evaluation of accepted health care and treatment patterns and programs; theories of fraud, abuse, or waste as it relates to health care programs

Managing multiple, sometimes conflicting priorities without jeopardizing deadlines and schedules

Computers and applicable computer software

 

Ability to:

View computer screens for long periods of time, up to six or more hours per day  

Move/lift boxes of documents, laptop, portable scanner, and other portable computer equipment necessary for onsite audits

Interact effectively with people at all organizational levels

Foster a team environment and contribute to the professional development of assigned personnel

Apply quantitative and qualitative methods of analysis, detection, and measurements of fraud, waste, or abuse

Apply nursing knowledge, practices, and procedures to components of job and in consultation

recognize patterns of medically necessary treatment and assessment of appropriate use of medical services

Interpret medical documents, including charts, narratives, plans of treatment and diagnosis.

function well as a team member

Establish and maintain positive, effective working relationships 

Position Information

Class Code: L038C

Grade: MP01

FLSA Status: EXEMPT

Salary Range: $63,830.00 - $88,058.00

Summary

The Registered Nurse is responsible for providing direct patient care and the provision of other patient services in a clinical setting. This position is governed by state and federal laws, and agency/institution policy.

Functions

Records medical and family history of patients and current medication usage, conducts physical examinations, and monitors vital signs. Develops and updates patient care plan for completion of treatment goals. Reviews patient charts for physician orders, progress notes, and physical complaints. Consults with physicians concerning problem cases, provides assistance with case management, and refers patients to appropriate clinic or agency for treatment. Responds to emergency or life-threatening situations and administers appropriate treatment. Counsels and instructs patients and family members on proper care and use of medication and medical equipment, modifies care plan according to patient's progress, and informs of available services, if providing care in the home or hospital. Instructs individuals, families, and other groups regarding health issues, such as preventive care, nutrition, and childcare. Arranges for immunizations, blood pressure testing, and other health screening. Works with community leaders, teachers, parents, and physicians in community health education. May supervise daily activities of licensed practical nurses and nursing aides. Performs other duties as assigned.

Dimensions

May be required to work rotating shifts or hours other than normal working hours or to be on call.

Knowledge, Skills and Abilities

Knowledge of professional nursing theories, concepts, and methods. Ability to develop patient care plan and participate in diagnosis and development of treatment goals. Ability to apply comprehensive nursing care to clients in all age groups in a clinical setting. Ability to assign and coordinate work activities and monitor the performance of subordinates. Ability to instruct patients and families on self-help care. Ability to assist physicians with routine and emergency care.

Minimum Qualifications

The formal education equivalent of a diploma, associate's, or bachelor's degree in nursing.  Must be licensed as a Registered Nurse by the Arkansas State Board of Nursing in accordance with ACA 17-87-307.  Additional requirements determined by the agency for recruiting purposes require review and approval by the Office of Personnel Management. OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.

Licenses

None

The State of Arkansas is committed to providing equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, pregnancy, age, disability, citizenship, national origin, genetic information, military or veteran status, or any other status or characteristic protected by law.


Nearest Major Market: Little Rock