Registered Nurse 2 (Medical Care)
Job
State of New York - Insurance Fund, State
Remote
Full-Time
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Job Description
The duties that the incumbent of the vacancy will be expected to perform. Duties Description Registered Nurse 2 (Medical Care) positions at NYSIF are responsible for coordinating global case management of high-cost complex cases and are an extensive resource for the NYS Workers' Compensation Board Medical Treatment Guidelines for Claims Service Managers and other Claims staff.
Responsibilities include, but are not limited to:
Appointments via transfer must not result in a second, consecutive transfer with anadvancement of more than two S-grades or one M-grade. Eligible titles include, but arenot limited to: Registered Nurse 1, Registered Nurse 1 (Health Services), RegisteredNurse 1 (Spanish Language).
Responsibilities include, but are not limited to:
- Perform claimant outreach
- Perform catastrophic and/or high-cost claims management
- Review and process PARS for surgeries and DME
- Perform claims management
- Participate in utilization review audits
- Review and calculate payments for pharmaceutical bills
- Facilitate and negotiate claimant discharges from inpatient hospitalizations
- Serve as a resource to claims staff in providing effective medical knowledge and management of these claims
- Identify and manage high medical exposure claims for NYSIF
- Contact claimants and providers, facilities, families, employers, etc.
NY HELPS
- Possession of a license and current registration as a registered professional nurse in New York State; and one year of post-licensure clinical nursing experience in the following areas: rehabilitation, medical/surgical, public health, community health, visiting nursing, occupational health, utilization review, or review of medical records from hospitals for appropriate ICD 9 or 10/DRG/PAS/CPT coding.
Transfer:
Current New York State employee with one year of permanent competitiveclass service in a title eligible for transfer under Section 70.1 of Civil Service Law.Appointments via transfer must not result in a second, consecutive transfer with anadvancement of more than two S-grades or one M-grade. Eligible titles include, but arenot limited to: Registered Nurse 1, Registered Nurse 1 (Health Services), RegisteredNurse 1 (Spanish Language).
Reinstatement:
Candidates who have held a Registered Nurse 2 (Medical Care) title, or atransferable title, may be eligible for consideration for reinstatement.Preferred Qualifications:
- Experience with case management and CCMPlease be advised that the New York State Insurance Fund (NYSIF) does not offer sponsorship for employment visas to employees or potential employees.
Fringe Benefits:
- Competitive compensation
- Future career growth potential
- Open and supportive team-based environment
- Plentiful vacation, personal, and sick time off
- Paid state and federal holidays
- Affordable health insurance plans
- Dental and vision benefits provided at no additional cost
- Retirement options
- Public Student Loan Forgiveness (PSLF)
- Possibility of telecommuting, flextime, and Alternative Work Schedules (AWS)
NY HELPS Program:
This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS). For the duration of theNY HELPS
Program, this title may be filled via a non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the title for which they apply. At a future date, it is expected employees hired underNY HELPS
will have their non-competitive employment status converted to competitive status, without having to compete in an examination. Employees will then be afforded with all the same rights and privileges of competitive class employees of New York State. While serving permanently in aNY HELPS
title, employees may take part in any promotion examination for which they are qualified.About NYSIF:
For more information about NYSIF, including our mission, commitment to diversity, equity, and inclusion, and efforts to fulfill Executive Order 31, please visit www.nysif.com. If you are a person with a disability and wish to request that a reasonable accommodation be provided for you to participate in a job interview, please send an email to NYSIF's Reasonable Accommodations mailbox at ra@nysif.com. Some positions may require additional credentials or a background check to verify your identity.Similar jobs in Melville, NY
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