DEDICATED TO STRENGTHENING THE HEALTH, SAFETY, AND INDEPENDENCE OF IDAHOANS

• excellent medical, dental and vision insurance - (full-time/30+ hours per week) employee only coverage for PPO $65/month for medical and vision & $11.00/month for dental
• generous vacation and sick leave accrual beginning as soon as you start
• 11 paid holidays a year
• paid parental leave
• multiple savings plans, optional 401K, and optional 457
• basic life insurance for employee and family
  • employee covered at one times annual salary
  • spouse covered at $10,000
  • child covered at $5,000
• wellness programs
• ongoing training opportunities
• an opportunity for student loan forgiveness
• and more!

• This position will be working under the direction of the Performance Improvement and Accreditation Director
• This position also requires applicants to become certified in CPR and Nonviolent Crisis Intervention.

• 
  Performs admission certification review, and concurrent/retrospective an evaluation of patient care needs to determine level of services required, appropriateness of continued stay. Sends copies of utilization review activities to the Department of Health and Welfare and to Medicaid.
• Processes Appeals of Denial and ensures when indicated that medical records are sent to Managed Care Agencies.
• Reviews medical records in the event of denied coverage or benefits and notifies the attending physician of denials and schedules retro-reviews and physician to physician reviews as needed.
• Reports over-utilization, under-utilization, and inefficient scheduling of resources to appropriate Hospital officials.
• Recommends policy and systems changes that encourage the consistent provision of high-quality patient care and continual improvement in the utilization of patient care services.
• Works with the treatment team with External Professional Review Organizations for claims, approval authority, review of care, and case management coordination for third party reimbursement decisions. Maximizes the Hospital’s potential for secured payment from third party payers.
• Skills in performing needs assessments, developing training objectives, designing, and developing coursework and evaluating the training; presenting training to adult groups in structured learning situations; using a variety of training methods. Additionally, incumbent will need to possess necessary computer skills to develop computer-based training.
• Working alongside the SHW team to ensure compliance with Joint Commission, CMS, and State Licensure standards. Assist supervisors with staff development plans and orientation and training.

• Help in developing, disseminating and monitoring training materials and plans for SHW staff including New Employee Orientation and all staff annual training.
• Responsible to plan and coordinate the hospital-wide annual review in conjunction with the Executive Leadership Team. Ensure staff are scheduled and notified of required attendance.

• 
  Participates in review of operational findings and works cooperatively with regional and central office staff to suggest, support, and implement strategies.

• Licensed as a Professional or Registered Nurse in Idaho as defined by Idaho Code 54-1408 or state licensure as a Registered Nurse pursuant to the Nurse Licensure Compact, Idaho Code 54-1418, in one of the following compact states: Arizona, Arkansas, Colorado, Delaware, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, or Wisconsin.

• Performing nursing assessments and developing and implementing nursing care plans.

EXTRA CREDIT:

Below are questions for extra credit. They are not required, however, having the minimum qualifications and the education and/or experience below will increase your score.

• Some experience with insurance and medical billing. Gained by at least one year of previous work experience in this area.
• Some experience with utilization review. Gained by at least one year of previous work experience in this area.
• Working knowledge of Microsoft Office Products (Word, Excel, Teams, PowerPoint). Gained by at least two years of experience working with Microsoft Office Products.
• Experience interpreting and reporting out basic data. Gained by at least two years of previous work experience in this area.

People Making A Difference!

VISIT US ONLINE
Learn About a Career with DHW
https://healthandwelfare.idaho.gov/about-dhw/dhw-careers

For all Idaho state government jobs:
https://dhr.idaho.gov

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***PLEASE NOTE: application assistance is not available after the business hours listed below, on the weekends, or on holidays and you must apply before 11:59 pm on the closing date. When applying, use CHROME as your browser to avoid complications.
If you have questions, please contact us at:

TROUBLE APPLYING: 1-855-524-5627

(Monday through Friday, 6am - 5pm, Pacific Time)

EMAIL:

dhwjobs@dhw.idaho.gov
(answered Monday through Friday during business hours MST)

Email is the quickest way to get an answer to your questions.

PHONE:

(208) 334-0681
(answered Monday through Friday during business hours MST)

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EEO/ADA/Veteran's Preference

The State of Idaho is committed to providing equal employment opportunities and prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on their race, color, religion, political affiliation or belief, sex, national origin, genetics, or any other status protected under applicable federal, state, or local laws.

The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities, auxiliary aids and services are available upon request. If you require an accommodation at any step in our recruitment process, you are encouraged to contact (208) 334-2263 (TTY/TTD: 711), or email ada.coordinator@dhr.idaho.gov.

Preference may be given to veterans who qualify under state and federal laws and regulations.