Rem Quality Improvement Nurse

State Of Maryland

Not Interested
Bookmark
Report This Job

profile Job Location:

Baltimore, MD - USA

profile Monthly Salary: Not Disclosed
Posted on: Yesterday
Vacancies: 1 Vacancy

Job Summary

GRADE

20

LOCATION OF POSITION

MDH - Division of Childrens Services
201 W. Preston Street
Baltimore MD 21201

Main Purpose of Job

The main purpose of this Medical Services Reviewing Nurse II position is to perform quality improvementactivities within the Rare and Expensive Case Management (REM) program. This positionworks directly with the REM case management contractor to assure that the REMenrollees are receiving appropriate case management and medical services per the REMcontract requirements. The review nurse communicates with the REM case managementcontractors and/or the REM case managers regarding potential obstacles to care(reportable events).

MINIMUM QUALIFICATIONS

Education: A Bachelors degree in Nursing or a related field from an accredited college or university.

Experience: One year of experience reviewing medical services claims to ensure that the nature and quality of services are in accordance with State and federal regulations.

Notes:

1. Candidates may substitute two years of experience as a Registered Nursefor the required education.

may substitute U.S. Armed Forces military serviceexperience as a commissioned officer in Nursing classifications orNursing specialty codes in the Nursing field of work on a year-for-year basis for the required education.

DESIRED OR PREFERRED QUALIFICATIONS

The desired candidate should possess the following:
  • Previous experience in case management services and quality assurance review and reporting.
  • Experience with Maryland Medicaid Information System Subsystems (MMIS) and/or LTSS.
  • Experience with applicable state and federal laws regulations and requirements.
  • Experience with Microsoft Office and Google applications.
  • Experience with Institutional Billing and Medicaid Waiver programs.

LICENSES REGISTRATIONS AND CERTIFICATIONS

1. Candidates for positions in this classification must possess a current license as a Registered Nurse from the Maryland State Board of Nursing 4140 Patterson Avenue Baltimore Maryland 21215 or possess a current multi-state licensein party states that candidates have declared as primary states of residence.

2. Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operators license valid in the State of Maryland.

SELECTION PROCESS

Applicants who meet the minimum (and selective) qualifications will be included in further evaluation. The evaluation may be a rating of your application based on your education training and experience as they relate to the requirements of the it is essential that you provide complete and accurate information on your report all related education experience dates and hours of indicate your college degree and major on your application if applicable. For education obtained outside the U.S. any job offer will be contingent on the candidate providing an evaluation for equivalency by a foreign credential evaluation service prior to starting employment (and may be requested prior to interview).

Complete applications must be submitted by the closing submitted after this date will not be added.

Incorrect application forms will not be will not be accepted in lieu of a completed application.

Candidates may remain on thecertified eligible list for a period of at least one year. The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.

BENEFITS

FURTHER INSTRUCTIONS

Online applications are highly recommended. However if you are unable to apply onlinethe paper application (and supplemental questionnaire) may be submitted to MDH Recruitment and Selection Division 201 W. Preston St. Room 114-B Baltimore MD application materials must be received by 5 pm close of business on the closing date for the recruitment no postmarks will be accepted.

If additional information is required the preferred method is to upload. If you are unable to upload please fax the requested informationto .Only additional materials that are required will be accepted for this recruitment. All additional information must be received by the closing date and time.

For questions regarding this recruitment please contact theMDH Recruitment and Selection Division at .

If you are having difficulty with your user account or have general questions about the online application system please contact the MD Department of Budget and Management Recruitment and Examination Division at or.

Appropriate accommodations for individuals with disabilities are available upon request by calling: or MD TTY Relay Service 1-.

We thank our Veterans for their service to our country.

People with disabilities and bilingual candidates are encouraged to apply.

As an equal opportunity employer Maryland is committed to recruitment retaining and promoting employees who are reflective of the States diversity.

MDHMedCare


Required Experience:

IC

GRADE 20 LOCATION OF POSITION MDH - Division of Childrens Services201 W. Preston StreetBaltimore MD 21201Main Purpose of Job The main purpose of this Medical Services Reviewing Nurse II position is to perform quality improvementactivities within the Rare and Expensive Case Management (REM...
View more view more

Key Skills

  • EMR Systems
  • Hospital Experience
  • Acute Care
  • ICU Experience
  • Dermal Fillers
  • Experience Administering Injections
  • Home Care
  • Nursing
  • Botox Experience
  • Critical Care Experience
  • Medication Administration
  • Tube Feeding

About Company

Company Logo

Open Maryland

View Profile View Profile