Disability Determination Nurse (Medicaid Health Systems Specialist - RN)

Ohio Department of Medicaid; Columbus (OH); On-site; USD 80,000 - 100,000; Full time

Job summary

An established industry player is seeking a Disability Determination Nurse to assess and make clinical decisions regarding disability claims. This role involves reviewing medical records and collaborating with healthcare providers to ensure accurate evaluations. You'll be part of a dedicated team focused on delivering high-quality, person-centric healthcare services to Ohioans. The position offers a comprehensive benefits package and opportunities for professional development. If you're passionate about nursing and want to make a difference in people's lives, this is the perfect opportunity for you.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Paid Leave

Development Opportunities

Retirement Plans

Qualifications

• Requires a valid Ohio RN license and 24 months of nursing experience.
• Education and experience should align with the official position description.

Responsibilities

• Assess and make clinical decisions regarding disability.
• Review and evaluate medical records and reports.
• Interact with providers and stakeholders using software.

Skills

Nursing

Interpreting Data

Health Administration

Education

Current Ohio RN License

Relevant Education

Job description

Job Description - Disability Determination Nurse (Medicaid Health Systems Specialist - RN) (250003JN)

This position involves assessing and making clinical/medical decisions to determine disability, reviewing medical records, and interacting with healthcare providers and stakeholders using electronic documentation and software applications.

Organization

Medicaid

Contact: [e-mail]

Unposting Date

May 12, 2025, 3:59 AM

Work Location

Lazarus 4, 50 West Town Street, Columbus, OH 43215

Primary Location

United States of America, Ohio, Franklin County, Columbus

Compensation

$33.45/hour

Schedule

Full-time

Union

1199

Primary Job Skill

Nursing

Technical Skills

Nursing

Professional Skills

Interpreting Data

Agency Overview

About Us: The Ohio Department of Medicaid supports Ohio’s vision for a high-quality, person-centric healthcare system, serving nearly one in four Ohioans through personalized care, improved services, and operational transparency.

• Delivering personalized care to over three million people
• Enhancing care for children and adults with behavioral health needs
• Collaborating to improve wellness and health outcomes
• Streamlining administrative processes for providers
• Ensuring financial transparency across programs

What You Will Do at ODM:

Office: Operations

Bureau: Business Operational Support

Classification: Medicaid Health Systems Specialist (PN 20047592)

Job Overview:

• Utilize Ohio Administrative Code and federal policies to make definitive clinical/medical decisions regarding disability
• Review and evaluate medical records and reports
• Use electronic medical documentation and software, interacting with providers and stakeholders

Why Work for the State of Ohio

We offer comprehensive benefits including medical, dental, vision, life insurance, paid leave, development opportunities, and retirement plans. Benefits depend on eligibility and position specifics.

Qualifications

Requires a current, valid Ohio RN license and 24 months of nursing experience, or alternative qualifications including relevant education and experience, or substitution with Medicaid Health Systems Analyst experience. Education and experience should align with the official position description.

Job Skills

Health Administration

Supplemental Information

Travel may be required. Candidates must provide own transportation or hold a valid driver’s license for state vehicle operation. Resumes are not reviewed; detailed work experience is essential in application. Final candidates will undergo a criminal background check, with considerations for prior convictions in context.

Additional Notes

Ohio promotes disability inclusion and maintains a drug-free workplace policy, including restrictions on recreational marijuana use.