Public Health Nurse Specialist

4 days ago

Indianapolis, Indiana, United States state of indiana Full time
About the Role

We are seeking a highly skilled Nurse Specialist to join our team at the State of Indiana. As a key member of our healthcare team, you will play a critical role in determining medical eligibility for applicants and providing prior authorization of services to families of participants with serious, chronic medical conditions.

Key Responsibilities
  • Review medical records and application documents to determine program eligibility and ensure compliance.
  • Coordinate with participants, families, healthcare and insurance providers to obtain additional information and make changes to documentation as needed.
  • Interpret applicable medical terminology, clinical procedures, regulations, and policies to update possible medical diagnoses needs for program participants, recommend medical solutions, and/or make referrals as needed.
  • Provide program explanation and technical assistance to participants and families.
  • Prepare documentation and attend appeals hearings as needed in the event that a participant is denied authorization of services or medical eligibility.
Requirements
  • A Bachelor's Degree with a Registered Nurse (RN) license, or an Associate's Degree with a Registered Nurse (RN) license plus 1+ years of experience applying the below, outlined knowledge, skills, and abilities in a similar role.
  • Specialized knowledge of nursing principles, techniques, and medical needs as applied to the population served.
  • Considerable knowledge of and the ability to review and analyze medical records and documents.
  • Considerable knowledge of program rules and policies.
  • Specialized knowledge of rehabilitation, including therapy and durable medical equipment.
  • Working knowledge of insurance and Medicaid/Hoosier Healthwise.
  • Ability to communicate verbally and in writing with individuals and in group situations.
  • Ability to be flexible and maintain composure under stressful situations.
Benefits of Employment with the State of Indiana
  • Three (3) medical plan options (including RX coverage) as well as vision and dental plans.
  • Wellness Rewards Program: Complete wellness activities to earn gift card rewards.
  • Health savings account, which includes bi-weekly state contribution.
  • Flexible work scheduling options, including the potential for hybrid remote work for employees whose work may be performed outside state facilities.
  • Deferred compensation 457B account (similar to 401k plan) with employer match.
  • Two (2) fully-funded pension plan options.
  • A robust, comprehensive program of leave policies covering a variety of employee needs.
  • Combined 180 hours of paid vacation, personal, and sick leave time off.
  • 12 paid holidays, 14 on election years.
  • Education Reimbursement Program.
  • Group life insurance.
  • Referral Bonus program.
  • Employee assistance program that allows for covered behavioral health visits.
  • Qualified employer for the Public Service Loan Forgiveness Program.
  • Free Parking for most positions.
  • Free LinkedIn Learning access.
Equal Employment Opportunity

The State of Indiana is an Equal Opportunity Employer.

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