Nurse

Nurse Consultant Duties

For Nurse Consultant, GS-0610-12:

Communicates and coordinates with health care providers to assess appropriate levels of home health care to ensure the care the claimant receives reflects the policies and procedures of DEEOIC.

Coordinates and conducts outreach and training to medical providers and other stakeholders, program staff, other Federal Agencies, and the general public.

Under the direction and leadership of the Lead Nurse and Unit Manager, the employee plans and implements assignments, projects, and/or studies in the areas of home health care, durable medical equipment, and other medical issues.

Utilizes current medical and scientific knowledge, medical journals, reference manuals, books, the DEEOIC Procedure Manual and related policy, and other resources to develop rationale for his/her opinions.

Provides input for accurate application of medical guidelines to the processing of medical services by serving as a resource for medical billing issues.

The employee develops training materials for DEEOIC staff, health care providers, and beneficiaries.

Works with the Medical Bill Pay staff or other National Office staff to monitor procedures and evaluate their validity and cost-effectiveness by the utilization of models from Medicare and other federal agencies.

Within the assigned area, determines medical appropriateness of requested ancillary procedures and/or services that require authorization by senior management.