Location: Tallahassee, FL
Company: Florida Department Of Transportation
This position is NOT a remote position.
Licensure as a Registered Professional Nurse in accordance with Chapter 464, Florida Statutes, or eligible to practice nursing in accordance with Florida Administrative Code 210-8.27, and four (4) years of professional nursing experience is required.
A bachelor's degree from an accredited college or university with a major in nursing can substitute for one (1) year of the required general professional nursing experience. A master's degree from an accredited college or university in nursing can substitute for two (2) years of the required general professional nursing experience. Preferences: Professional nursing experience in a supervisory
or administrative capacity. Experience in workers' compensation medical case management Experience reviewing medical records and medical bills Experience monitoring contracts for medical services The annual salary for this position will range from $60,000.00 - $66,103.00, depending upon experience and qualifications.
Employees of the Department of Financial Services are paid on a monthly pay cycle. Scheduled working hours will be between the core business hours of 7:30 a. m. and 5:00 p. m. Monday through Friday. This position requires a security background check, including fingerprint as a condition of employment. Responses to qualifying questions must be clearly supported by the state
application and any omission, falsification, or misrepresentation in the answering of the qualifying questions will be cause for immediate elimination from the selection process.
Minimum Qualifications for this position include the following REQUIRED ENTRY LEVEL KNOWLEDGE, SKILLS, AND ABILITIES: Knowledge of nursing principles, practices, and techniques. Knowledge of human anatomy and physiology. Knowledge of methods of compiling, organizing, and analyzing data. Ability to develop and implement various program monitoring methodologies and techniques. Ability to provide in-service training on medical and health care services, patient backssments, and utilization practices.
Ability to develop program policy, procedures, manuals, administrative rules, and agreements. Ability to understand and apply applicable rules, regulations, policies, and procedures. Ability to prioritize workload. Ability to plan, organize and coordinate work assignments. Ability to develop various reports. Ability to formulate and monitor nursing standards and operating policies and procedures. Ability to establish and maintain effective working relationships with others. Ability to communicate effectively verbally and in writing. BRIEF DESCRIPTION OF DUTIES: Provide nursing consultation and medical expertise to Division staff on workers' compensation claims concerning but not limited to evaluating medical care and supplies furnished by providers, appropriateness of the level of service provided, treatment rendered in relationship to the injury, codes billed versus the treatment actually rendered, and monitoring rehabilitation services.
Provide monitoring and oversight of shop benefits by conducting audits on selected bills processed by the vendor. Provide monitoring and oversight of medical bill review, re-pricing, and pre-certification programs by conducting audits on selected physician bills and hospital bills being processed in-house by the Division.
Assist in the planning and development of guidelines, policies and procedures for medical cost containment including developing, and implementing the Division's UR plan to comply with current statutory requirements. Provide monitoring and oversight of UR/QA activities of vendors providing medical related services. Provide nursing consultation and medical expertise, training, and technical assistance in the interpretation of program policies and reimbursement allowances of the Workers' Compensation Health Care Provider Reimbursement Manual.
Assist in the planning and implementation of a program to monitor the effectiveness and efficiency of processing medical bills by the Division. If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida. Your current retirement benefits may be canceled, suspended, or deemed ineligible depending upon the date of your retirement. The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.
Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-###-####). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation. The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F. S. Drug-Free Workplace Act. VETERANS' PREFERENCE. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans' Preference will receive preference in employment for Career Service vacancies and are encouraged to apply.
Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans' Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans' Preference documentation requirements are available by clicking here.
All documentation is due by the close of the vacancy announcement. Nearest Major Market: Tallahassee Associated topics: ccu, domiciliary, intensive, intensive care, neonatal, nurse, psychatric, registered nurse, surgery, surgical
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