Medicaid Review Nurse

1 week ago


Lincoln, Nebraska, United States State of Nebraska Full time

About the Role:

The State of Nebraska is seeking a skilled Medicaid Review Nurse to join our team at the Central Office. As a Medicaid Review Nurse, you will play a critical role in managing and processing Medicaid applications for incarcerated individuals, ensuring accuracy and completeness, and determining eligibility requirements.

Key Responsibilities:

  • Manage and process all Medicaid applications for incarcerated individuals, including distributing applications, reviewing for accuracy and completeness, and determining eligibility requirements.
  • Obtain additional documentation required for eligibility and submit applications to the HHS Medicaid division.
  • Maintain records of applications and track status.
  • Perform quality control duties involving medical services provided to the incarcerated population, including utilization review.
  • Serve as a contact for hospitals, outside providers, and HHS Medicaid on questions and issues related to the Medicaid project.

Requirements:

  • A current license to practice as a Licensed Practical Nurse in Nebraska or authority based on the Nurse Licensure Compact to practice as a Licensed Practical Nurse in Nebraska.
  • Experience with Interqual, the utilization review process, and Microsoft Office, particularly Excel.
  • Ability to perform audits and complete on-the-job training.

What We Offer:

The State of Nebraska offers a comprehensive package of pay, benefits, paid time off, retirement, and professional development opportunities to help you get the most out of your career and life.


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