30 Aug → 29 Sep
Frankfort, KY 40601, USA
The Nurse Consultant in the division of Quality and Outcome will have the opportunity to work with friendly colleagues, in an atmosphere that can be challenging but rewarding. The Division of Quality and Outcomes measures analyzes and reports health outcomes of Kentucky Medicaid members. The division oversees managed care organization (MCOs) to ensure compliance with all federal and state regulations and contract provisions. As an employee within the division, you have the continuous ability to learn and display your skills in order to make a difference in the lives of the most vulnerable of the medicaid population.
The agency may authorize the selected candidate to telecommute. The candidate may need to report to the office as needed. The agency may terminate or modify the telecommuting arrangement at any time.
- Provides technical assistance and consultative services for the development of quality measures for the fee for service programs in the Department for Medicaid Services.
- Develop and recommend initiatives for the program to ensure quality of services delivered to recipients.
- Provides policy interpretation for children's health issues to include revision of regulations, responding to inquiries from Medicaid providers, general public, Medicaid recipients and the legislative body; reviews service codes and researches Medicaid claim issues.
- Attends advisory groups and council meetings representing the division/department and providing expertise in the area of children's health.
- Monitors assigned provider contracts that includes services for children; such as, monitoring reports to ensure contract is meeting the required services that are delivered to Medicaid members.
Requirements / Qualifications
- Licensed in Kentucky as a registered nurse.
- Must have four years of experience as a Registered Nurse.
- A bachelor's degree in nursing will substitute for the required experience.
- Claims and coding knowledge preferred.
- Clinical input on child health related policies.
How To Apply
Apply through GoRemotely.