The Louisiana Department of Health is dedicated to fulfilling its mission through direct provision of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner.
LDH serves as a model employer for individuals with disabilities.
This position is located within the Louisiana Department of Health / Medical Vendor Administration / Program Integrity / East Baton Rouge Parish Announcement Number: MVA/SP/192771 Cost Center: 3052010700 Position Number: 50667434This vacancy is being announced as a Classified position and will be filled as a Job appointment.
(Job appointments are temporary appointments that may last up to 48 months)
Possession of a valid Louisiana license or temporary permit to practice professional nursing or a multi-state license issued by a Nursing Licensure Compact (NLC/eNLC) state plus three years of professional nursing experience is required.No Civil Service test score is required in order to be considered for this vacancy.
Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.
*Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.
*A resume upload will NOT populate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive creditFor further information about this vacancy contact:
Shambrielle Pooler
Shambrielle.Pooler@la.gov
LDH/HUMAN RESOURCES
BATON ROUGE, LA 70821
This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.
Plans, develops, implements and monitors facility wide multi-disciplinary programs, i.e. to coordinate facility wide activities related to quality control including, but not limited to: Infection Control, Discharge Planning, Quality Assurance, DRG
Coordinator, Utilization Review, and Support Service Review.
Advises and assists management relative to program assignments.
Determines staff and equipment needs to accomplish program missions.
Participates in establishment and monitoring of patient classification systems.
Collects statistical data and completes routine calculations for budget, recruitment, and placement reports.
Performs on-site observations and audits for accuracy of information.
Evaluates program goals and effectiveness in the facility and adapts/revises as necessary.
Participates in planning, directing, implementing, and evaluating varied, complex and multifaceted utilization review and support service activities.
Participates in monitoring quality of support services against established standards.
Participates in assessment of learning needs of staff relating to utilization review activities.
Collects, categorizes, and analyzes utilization results.
Provides professional consultation relative to program area to all professional staff.
Assesses support service practices for efficiency, quality of service, and cost effectiveness.
Identifies, assesses, and monitors utilization review problems and recommends corrective action.
Reviews, updates, and establishes policies and procedures for utilization review.
Monitors all admissions and performs admission reviews, continued stay reviews, discharge planning reviews, and maintenance plan reviews according to criteria.
Develops, implements, directs and monitors the facility Employee Health Program.
Provides orientation and employee education concerning employee health.
Implements the annual TB skin testing program.
May provide direct patient care when it relates to infection control or employee health.
Develops a program for identification, monitoring, and control of factors that contribute to infection.
Serves as resource consultant to nursing and medical staff when it relates to agency wide programs.
Performs a retrospective utilization review of hospital bills selected for audit by predetermined criteria and isolates possible questionable charges or procedures which may be included in the bill in error.
Provides information concerning various medical diagnoses and especially the corresponding procedures and treatments, length of stay or treatment necessary per diagnosis, and proper medication and intervals.
Using the retrospective utilization review, provides the auditors with a foundation or plan to follow in their audit of the hospital bill. This plan will detail the RN's review, providing the auditors with questionable charges or procedures, reasons why they are questionable, and any pure errors or mischarges found in review.
Coordinates audit plan with auditors to assure efforts are concentrated in areas of interest or possible error.
Serves as advisor or mediator in discussions with hospital personnel.
Reviews auditor work papers to ensure completeness and proper documentation of audit findings and aid in the development of criteria to select items to be audited.