Nurse Case Manager II

Nurse Case Manager II The Mississippi Division of Medicaid responsibly provides access to quality health coverage for vulnerable Mississippians. Medicaid provides health coverage for eligible, low-income populations in Mississippi. These populations include children, low-income families, pregnant women, the aged and disabled. This is a non-state service time limited position. The Nurse Case Manager II is responsible for performing program compliance functions for assigned Medicaid program areas. This position is responsible for conducting provider audits in accordance with EPSDT and FPW requirements and ensuring accurate documentation and timely communication with providers based on the audit findings. The Nurse Case Manager II will coordinate with appropriate program areas to support program integrity activities and complete the required reporting and training. The Nurse Case Manager II will work independently, exercise professional judgment, and collaborate with team members and supervisors to meet program deadlines and compliance standards. This position is ideal for an individual seeking a case management position, while maintaining an open line of communication with healthcare providers and their support staff. What you'll need to be successful: The candidate for this position should have a functional working knowledge of each of the following: Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) guidelines, Family Planning Waiver (FPW), Medicaid policy, and provider reimbursement requirements. Strong analytical and organizational skills with attention to detail are desired to ensure success in interpreting audit guidelines, coverage policies, and claims data. Advanced written and verbal communication skills are required, as well as proficiency in Microsoft Office products and electronic document management systems. The candidate should be a self-starter and possess the ability to work independently, manage multiple priorities and projects simultaneously, and maintain a personal time management system that ensures deadlines are being set and achieved appropriately. GovernmentJobs.com