SanAngeloRecruiter
the smart solution for San Angelo jobs

Nurse IV

Company: Texas Health & Human Services Commission
Location: San Angelo
Posted on: May 11, 2019

Job Description:

The Nurse Reviewer plans and conducts reviews and investigations, prepares reports and makes appropriate notification for the Office of Inspector Utilization Review Unit. Works under limited supervision with considerable latitude for the use of initiative and independent judgment. Conducts utilization reviews for Medicaid recipients in Medicaid approved hospitals to determine accuracy of the diagnosis and procedure coding, to ensure accurate payment and to review the quality of care provided. Conducts MDS assessment and reimbursement reviews in Medicaid approved nursing facilities to determine the accuracy of assessment data provided by the nursing facility to ensure accurate payment. Performs other duties as assigned and required to maintain unit operations. The Nurse Reviewer lifts up to 40 pounds, walks extended distances and travels approximately 75% of the time.Essential Job Functions:Conducts hospital and nursing facility medical investigations and reviews to determine accuracy of data. Conducts investigations and examinations of alleged violations of laws, rules and regulations regarding fraud in Medicaid coding. Conducts utilization reviews on Medicaid recipients in Medicaid approved hospitals to determine necessity of admission and the accuracy of diagnosis and procedural coding. Conducts MDS assessment reviews in Medicaid approved nursing facilities. Demonstrates interpersonal skills to facilitate a team approach.Knowledge Skills Abilities:Knowledge of case review, analysis evaluation, detailed case documentation, defining problems and making appropriate decisions. Knowledge of federal and state Medicaid policies and procedures. Knowledge of medical diagnosis, procedures and accepted medical treatment patterns. Skill in interviewing techniques, organization of work and multiple tasks. Skill in communicating effectively, orally and in writing. Skill in establishing and maintaining effective working relationships. Able to work under pressure, perform work under general supervision. Able to maintain a professional attitude. Able to conduct fraud and abuse investigations. Ability to travel extensively (up to 75%) with some overnight travel required.Registration or Licensure Requirements:Licensed to practice as a Registered Nurse in the State of Texas or in a state recognized under the Compact Licensure Agreement. License is current and in good standing.Initial Selection Criteria:Completed application with detailed work history, two years full-time experience as a practicing Registered Nurse in both skilled nursing facilities and/or hospitals highly preferred. Current licensure in good standing. Graduation from an accredited school of professional nursing, college or university is required. Ability to travel 75% of the time. Prior knowledge and work history.Additional Information:Interview process includes work-related exercise. Upon final selection and contingent offer, candidate must provide a certified copy of a college transcript and submit to criminal history background verification. The posted salary range reflects the minimum and maximum allowable by state law. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual Chapter 7.HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.MOS Code:Note: Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include: 68C, 66N/P/W, 290X, 46FX, 46NX, 46SX. For more information see the Texas State Auditor's Military Crosswalk at http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx.requisition 368390HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.I-9 Form - Click here to download the I-9 form.In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Keywords: Texas Health & Human Services Commission, San Angelo , Nurse IV, Healthcare , San Angelo, Texas

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Medical Technologist (MT)/Medical Lab Technician (MLT) Ful
Description: Medical Technologist MT /Medical Lab Technician MLT Ful We are looking for a Medical Technologist, for the evening shift, perm position in Abilene, Texas with competitive pay excellent
Company: Blue Royal Staffing
Location: Abilene
Posted on: 05/26/2019

Two Family Physicians Needed One Hour Outside of Abilene (Physician #7
Description: BC/BE Family Medicine physician s needed to practice at the largest regional medical center
Company: The Curare Group, Inc
Location: Abilene
Posted on: 05/26/2019

Primary Care Physician needed for Abilene State Supported Living Cente
Description: Primary Care Physician needed for Abilene State Supported Living Center br br
Company: Goldfish Medical Staffing
Location: Abilene
Posted on: 05/26/2019


Registered Respiratory Therapist - Full Time Permanent
Description: br Full-time, permanent opportunity for a Registered Respiratory Therapist--with competitive pay and excellent benefits br br Abilene is known for a vibrant downtown featuring small businesses, (more...)
Company: Blue Royal Staffing
Location: Abilene
Posted on: 05/26/2019

Orthopedic Surgeons-Come Home To Midwest, Tx
Description: We are looking for a Orthopedic Surgeon in Abilene, Texas. We offers a high quality of life both professionally and personally in our facility. The Physician must be BC/BE, needed to practice at the largest (more...)
Company: Medical On Demand
Location: Abilene
Posted on: 05/26/2019

Outpatient Option, Loan Repayment in Central Texas (Physician #353122)
Description: Medical Center located in central TX is seeking a board-certified or board-eligible internist to join a highly respected 40
Company: The Curare Group, Inc
Location: Abilene
Posted on: 05/26/2019

Hematology/Oncology Physician needed in the TEXAS MID WEST REGION (Phy
Description: Hematology/Oncology opening in Abilene, Texas. BC/BE Hematology/Oncology physician needed to practice at the largest regional medical center within 150 mile radius. Practicing and experienced
Company: National Health Partners
Location: Abilene
Posted on: 05/26/2019

Abilene, TX / Hematology/Oncology / Employment Opportunity (Physician
Description: Hematology/Oncology opening in Abilene, Texas. BC/BE HEMATOLOGY/ONCOLOGY br ABILENE, TEXAS br Hiring a BC/BE, Hematology/Oncology physician with employment/solo opportunity available in Abilene, TX. (more...)
Company: Source Medical
Location: Abilene
Posted on: 05/26/2019

Abilene, TX / Pediatrician / Busy Private Group with 25K Sign On Bonus
Description: Abilene, TX - about 2 hours West of DFW. Full Time and Permanent. Seeking BE/BC Pediatrician to join the largest regional medical center
Company: Source Medical
Location: Abilene
Posted on: 05/26/2019

Hematology/Oncology Physician-Are You Looking For A Great Work Life In Abilene, Tx
Description: We are looking for a Hematology/Oncology for a Group in Abilene, Texas. We offers a high quality of life both professionally and personally in our facility. The Physician must be BC/BE, needed to practice (more...)
Company: Medical On Demand
Location: Abilene
Posted on: 05/26/2019

Log In or Create An Account

Get the latest Texas jobs by following @recnetTX on Twitter!

San Angelo RSS job feeds