Job description
You have the passion, we have the opportunities – let’s make a difference for Nebraskans.
What we can offer you:
- Stable Employment Opportunity
- Career Development and Learning
- Tuition Reimbursement
- 156% match of first 4.8% contribution to Retirement Plan
- 13 Paid Holidays
- Generous Leave Accruals and Benefits
- Opportunity to be part of a caring organization
The State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex, age, national origin, disability, marital status, or genetics.
Job location is the Nebraska State Office Building, Downtown.
Monday-Friday, 8 AM-5PM
- Compile and analyze claims data and medical records;
- Interpret and apply State and Federal Medicaid rules and regulations to determine outcomes of cases investigated;
- Implement and/or recommend new and revised Medicaid policy, procedures, and provider bulletins; and
- Plan and coordinate audits and reviews including (but not limited to) the Payment Error Rate Measurement and Unified Program Integrity Audit Contractor audits.
*Must have ability to travel as projects/initiatives dictate, and work 8-5 core hours in addition to varied hours based on workload and project requirements.*
REQUIREMENTS: Post high school coursework/training in law enforcement, criminal justice, social/behavioral sciences or health related field, nursing, business or public administration, management, program analysis or evaluation of data systems OR Experience in conducting fraud investigations, administrative investigations, utilization review, data systems, review of records and reports and evaluating their use of effectiveness, policy planning/analysis, casework, nursing, accounting or billing systems.
PREFERRED: Higher preference may be given to those with experience working with Medicaid claims, MMIS, and/or Medicaid provider regulations. The ideal candidate will also have experience in working on projects and/or implementing new initiatives and be a Certified Professional Coder (CPC) or a registered nurse.
OTHER: Valid driver's license or the ability to provide independent authorized transportation. Ability to travel as projects/initiatives dictate, and ability to work 8-5 core hours in addition to varied hours based on workload and project requirements
Applicants must have excellent computer (word processing, database, spreadsheet, desk-top publishing, and on-line research) skills, and strong organizational and writing skills. Must be able to work efficiently and effectively as an individual and as part of a team. Attention to detail and accuracy, and a strong ability to handle multiple tasks concurrently are essential.
Check out all that the State of Nebraska has to offer! For more information on benefits currently offered to permanent teammates, please visit: https://statejobs.nebraska.gov/index.html#benefits
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