Nurse Case Manager II: Utilization & Audit Lead

State of Mississippi; Jackson (MS); On-site; USD 56,000 - 86,000; Full time

Job summary

State of Mississippi's Medicaid Division seeks a Nurse Case Manager II to conduct provider audits in Hinds County, MS. This full-time role supports program integrity with independent judgment and collaboration.

Responsibilities include reviewing documentation, coordinating with program areas, and producing required reports and training materials. Applicants should have RN licensure and strong analytical, communication, and Microsoft Office skills.

Qualifications

• State licensure as a Registered Nurse is typically required.
• 5+ years of experience preferred, especially in reviewing medical records.
• Strong analytical and organizational skills with attention to detail.

Responsibilities

• Conduct provider audits per Administrative Code guidelines.
• Coordinate with program areas to support integrity activities and reporting.
• Work independently and meet deadlines with compliance standards.

Skills

Analytical skills

Organizational skills

Written and verbal communication

Time management

Microsoft Office proficiency

Education

Registered Nurse licensure

Tools

Electronic document management systems

Job description

State of Mississippi's Medicaid Division seeks a Nurse Case Manager II to conduct provider audits in Hinds County, MS. This full-time role supports program integrity with independent judgment and collaboration.

Responsibilities include reviewing documentation, coordinating with program areas, and producing required reports and training materials. Applicants should have RN licensure and strong analytical, communication, and Microsoft Office skills.