Health Care Surveyor 2 (Nursing)

Open to the public.

Agency New York State Department of Health
Title Health Care Surveyor 2 (Nursing)
Salary *$50,452 - $62,432
Salary Grade Grade 19
Negotiating Unit Professional, Scientific and Technical/05
Location Office of Health Insurance Programs, Division of Provider Relations and Utilization Management, 150 Broadway, Menands, NY 12204
Minimum Qualifications Permanent Transfer Candidates: Current DOH employee with permanent status as a Health Care Surveyor 2 (Nursing) OR eligible for transfer under Section 70.4 of the Civil Service Law (NYS employee with one year of permanent service at G-17 or higher, and meeting the open competitive minimum qualifications listed below) --- Provisional Open Competitive Candidates: Possession of a license and registration as a Registered Professional Nurse in NYS AND one of the following: Two years of experience performing utilization reviews, claims adjudication, reviews of requests for medical services, medical review and/or investigations of fraud and abuse for third-party payers/designees or government entities; or surveillance/monitoring of entities licensed by or contracted by state, local and federal agencies; OR Three years of clinical or administrative nursing experience in a medical facility; OR Bachelor's Degree in Nursing and two years of clinical or administrative nursing experience in a medical facility.
Preferred Qualifications Experience in rehabilitation, home care, medical coding and automated healthcare systems; knowledge of laws, rules and regulations and policies relating to the Medicaid program; excellent interpersonal, communication, writing, analytical and computer skills; ability to work independently as well as part of a team; and ability to organize and prioritize.
Responsibilities The candidate will perform various utilization management functions, including reviewing prior approval requests to determine if the requested service falls within the scope of coverage of the Medicaid program and is appropriate for an individual's documented medical needs. The duties also involve utilizing procedure and diagnosis coding, reviewing appropriate combinations of medical services, identifying methods to prevent fraud and abuse and professional written and telephone communication with outside stakeholders
Conditions of Employment Transfer Candidates: Contingent-permanent full-time, normal business hours. --- Provisional Candidates: Provisional pending examination, full-time. Some travel may be required. Parking currently available on premises.
Application Procedure Submit resume to Human Resources Management Group, HCS2/89411/CB, Room 2276, Corning Tower Building, Empire State Plaza, Albany, New York 12237-0012, or by e-mail to resume@health.state.ny.us or by fax to (518) 474-6771. Please use a subject line of HCS2/89411/CB.
Submit resumes by until the position is filled

An affirmative action/equal opportunity employer. Women, minorities and people with disabilities are encouraged to apply.

Item # 89411
Issued June 27, 2008