Senior Medicaid Policy Nurse Consultant

Health & Human Services; North Carolina; Ibrido; USD 67.000 - 110.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health insurance

Retirement plans

Paid time off

Hybrid work option

Descrizione del lavoro

The North Carolina Department of Health and Human Services (NCDHHS) is seeking a licensed Registered Nurse with Medicaid policy expertise to analyze and maintain coverage policies, review complex requests, and support policy interpretation for program implementation. The role emphasizes collaboration with managed care plans, providers, and internal staff to improve policy accuracy and outcomes.

The position offers a hybrid work option, competitive compensation, and access to comprehensive state

Competenze

• Experience researching, analyzing, and interpreting complex Medicaid policies, regulations, standards, and guidance.
• Ability to develop clear, actionable recommendations for policy and program decisions.
• Strong written and verbal communication tailored to diverse audiences.

Mansioni

• Develop and maintain Medicaid coverage policies through analysis and evaluation.
• Review claims, coverage requests, and inquiries to inform decisions.
• Collaborate with plans, providers, and staff to ensure policy implementation.
• Evaluate trends and data to inform policy recommendations and operational improvements.
• Provide guidance to providers and stakeholders on Medicaid policies and requirements.

Conoscenze

Policy analysis

Medicaid policies

Regulatory interpretation

Stakeholder communication

Organizational skills

Formazione

Registered Nurse license (NC)

Descrizione del lavoro

The North Carolina Department of Health and Human Services (NCDHHS) is seeking a licensed Registered Nurse with Medicaid policy expertise to analyze and maintain coverage policies, review complex requests, and support policy interpretation for program implementation. The role emphasizes collaboration with managed care plans, providers, and internal staff to improve policy accuracy and outcomes.

The position offers a hybrid work option, competitive compensation, and access to comprehensive state