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Program Specialist RN

Nebraska Department of Health and Human Services Lincoln, NE
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Job Description

#TeamDHHS is looking for an individual who is team-oriented, possess exceptional communication skills and has their current RN License. The starting wage for this position is $25.972/hour however additional pay is based on experience. Apply for this Program Specialist-RN in our Medicaid and Long-Term Care Division!

Location: 301 Centennial Mall South; Nebraska State Office Building

This position is federally funded and may be governed by the Federal Hatch Act. Click here to review the Act.
EXAMPLES OF WORK:
Nebraska Medicaid is a progressive division of DHHS which includes a health care delivery system combining physical health, behavioral health and pharmacy programs into a single comprehensive and coordinated system. This position resides in the Professional and Institutional Services Unit with a core team of nurses and other program specialists working together to provide insurance related policy and direction for Nebraska Medicaid providers and clients. Communicate appropriate policies, procedures and interpretations for the coverage and delivery of medical programs to the participating managed care organizations, providers and clients. Provide consultation and resource information to other staff regarding coverage of medical services, items and supplies. Research medical information to determine medical necessity for prior approval of services and expectations. Perform medical/independent professional reviews and utilization reviews. Present information to agency staff, clients, providers and other agency staff on types of services and benefits available or aspects of new or revised assistance programs and services to educate and inform those involved of requirements and services available. Stay abreast of federal laws and best practice then that information apply to Medicaid policy. Collaborate with the Medical Director on quality improvement projects and other tasks as assigned.
QUALIFICATIONS / REQUIREMENTS:
REQUIREMENTS: Licensure as a Registered Professional Nurse in the State of Nebraska and experience working as a professional Registered Nurse.

PREFERRED: Experience in medical settings such as acute care, physician office and/or community health nursing. Experience working in an insurance setting; performing utilization review; and interpreting and applying federal/state regulations.

OTHER: Valid driver's license or ability to provide independent authorized transportation.
KNOWLEDGE, SKILLS AND ABILITIES:
Knowledge of the following: principles and practices of professional nursing theory; professional medical terms, diseases and physical conditions. Skills to include the following: experience with quality improvement and patient safety measures is beneficial to this position. Ability to do the following: establish and maintain positive relationships with agency staff, providers and clients; communicate effectively via memos, reports or group discussions with agency staff, service providers and others to promote, explain, discuss, advise and interact with them on various program issues and problems; interpret and explain in layman's language medical terms, diseases, conditions and treatment; maintain excellent writing skills; apply instructions, laws, rules, policies and procedures pertinent to the program.

Job Details

Date Posted November 7, 2017
Date Closes December 7, 2017
Located In Lincoln, NE
Department Medicaid and Long Term Care
Job Type Full-time Employee
Compensation Hourly Wage, $25.97, Based on Experience
SOC Category 29-1141.00 Registered Nurses
Zipcode 68509
Name Holly Socha
City, State and Zip Lincoln, NE 68528
Phone 402-471-9240

This job offers the following benefits

  • 401(a) Retirement Savings Plan
  • 457(b) Deferred Compensation Plan
  • College Savings Plan
  • Dependent-Care Spending Accounts
  • Flexible Spending Accounts
  • Health-Care Spending Accounts
  • Accidental Death and Dismemberment
  • Dental
  • Dependent Life Insurance
  • Employee Assistance Program (EAP)
  • Life Insurance
  • Long-Term Disability
  • Maternity / Paternity / Family Leave
  • Medical
  • Prescription Drug Plan
  • Vision
  • Voluntary Life Insurance
  • Bereavement Pay
  • Cafeteria / Food
  • Credit Union
  • Financial Planning
  • Flexible Hours
  • Paid Holidays
  • Paid Vacations
  • Sick Leave
  • Tuition Reimbursement
  • Wellness Program

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At a Glance
Enjoy these benefits
  • 401(a) Retirement Savings Plan
  • 457(b) Deferred Compensation Plan
  • College Savings Plan
  • Dependent-Care Spending Accounts
  • Flexible Spending Accounts
  • And More ...
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