Optometric Consultant

ND Health and Human Services; Bismarck (ND); Hybrid; USD 55,000 - 96,000; Part time

Job summary

ND Health and Human Services is seeking a Consulting Optometrist to work remotely in the Bismarck/Mandan area. You will review Medicaid prior authorization requests for optometric services and determine approvals or denials using the MMIS web portal.

The role requires ND licensure and strong Medicare/Medicaid policy knowledge to ensure compliant, timely decisions and professional guidance. You will support providers, interpret policies, and contribute to maintaining program integrity with clear

Qualifications

• Licensed optometrist in North Dakota.
• Understanding of Medicare and Medicaid vision policies and medical necessity determinations.
• Ability to interpret policies and make coverage decisions.

Responsibilities

• Review prior authorization requests for Medicaid optometric services.
• Provide clinical recommendations when policies are reviewed or updated.
• Ensure timely review within CMS regulations and respond to inquiries.

Skills

Licensed optometrist

Medicare/Medicaid policy knowledge

Clinical decision making

Written communication

Tools

MMIS web portal

Job description

Medical Services is seeking a Optometric Consultant to work remote in the Bismarck/Mandan area.

As North Dakota continues its commitment to becoming the healthiest state in the nation, you will play an important role in ensuring Medicaid members receive medically necessary optometric services that improve their health and quality of life.

As our Consulting Optometrist, you will review prior authorization requests for Medicaid optometric services for both adults and children receiving specialized vision care. Using the MMIS web portal, you will determine whether requested services meet Medicaid optometric services policy requirements for approval or denial.

You will provide clinical expertise and recommendations when Medicaid optometric services policies are reviewed or updated to ensure they align with current standards of care and support consistent decision-making.

You will review authorization requests within federally required timeframes to ensure compliance with Centers for Medicare & Medicaid Services (CMS) regulations while helping members receive timely access to medically necessary optometric services.

To succeed in this position, you should be an enrolled Medicare provider with a strong understanding of Medicare and Medicaid vision policies, clinical standards, and medical necessity determinations. You should be able to interpret policies, evaluate clinical information, and make sound decisions regarding coverage of vision services.

You should be flexible, detail-oriented, and comfortable providing professional guidance when questions or unique situations arise. Strong written communication skills and timely responses to emails and inquiries are essential to supporting providers, maintaining program integrity, and ensuring high-quality service.

To be considered for this position you must be a licensed optometrist in North Dakota.

This position is approximately 10 hours a month and is flexible when you would work.

Location

ND HHS utilizes a blended workplace model. This position may work from home anywhere in North Dakota.

About HHS

ND HHS strives to make North Dakota the healthiest state in the nation by reinforcing the foundations of well-being: physical, economic, and behavioral. The keys to success are the 2800 committed, team members who are guided by a simple but powerful belief: when we lead with light, we create systems and services rooted in hope, clarity, and possibility. Their work is supported with more than $6 billion in funding from nearly 400 different federal, state, and special sources.

To succeed in this role, you must lead with LIGHT - leading with hope, instilling purpose and meaning, galvanizing gratitude, honoring health, and talking, walking and teaching civility, kindness and love for all.

About Team ND

"Far and away the best prize life offers is the chance to work hard at work worth doing." - Theodore Roosevelt

More than 7,500 talented, hard-working people across sixty-three agencies have come together as Team North Dakota. At Team ND, we are driven to succeed through gratitude, humility, curiosity and courage. Our purpose is to empower people, improve lives, and inspire success. Join us in being legendary.

Total Rewards:

The State of North Dakota is committed to providing team members with a strong and competitive rewards package that support you, your health and your family.

Considering a new position on Team ND? How does your current position stack up? Use our Total Rewards Calculator to estimate.

Application Procedures

Your resume must clearly show the months and years of employment for each position listed. This information is required to accurately calculate your qualifying experience and determine whether you meet the minimum qualifications of the position. Resumes that do not include sufficient employment date may not be able to be fully evaluated.

Applicants must be legally authorized to work in the United States. The Department of Health & Human Services does not offer or provide sponsorships.

This employer participates in E-Verify. Please visit the following website for additional information HHS ND Careers E-Verify

A copy of your qualifying degrees transcript and any applicable certifications or licensures must be provided at the time of an interview.

For more information about the position or if you need an accommodation, please contact Susan Burns at [e-mail] or at [phone].

Employing Unit ND HHS - Medical Services

TTY Number ND Relay Service 1 [phone] (text) or 1 [phone] (voice)

If you are experiencing technical difficulties with the Application Process or uploading attachments, please contact [e-mail] or [phone].

Equal Employment Opportunity

The State of North Dakota and this hiring agency do not discriminate on the basis of race, color, national origin, sex (including sexual orientation and gender identity), genetics, religion, age or disability in employment or the provisions of services and complies with the provisions of the North Dakota Human Rights Act.

As an employer, the State of North Dakota prohibits smoking in all places of state employment in accordance with N.D.C.C. Sect. 23-12-10.