The MO HealthNet Division (MHD) is looking for a Registered Nurse Specialist for the Program for All-Inclusive Care of the Elderly (PACE) to join our team in the Program Operations Unit, located in Cole County.

Job Posting Number: 3640_8420027
Semi-monthly salary: $2,609.88

Annual salary: $62,637.12

Job Location: This position is located at the Howerton State Office Building; 615 Howerton Court, Jefferson City, MO 65109.

Why you’ll love this position: This position will provide clinical expertise in the areas of clinical compliance and quality for the MO HealthNet PACE program in Missouri. This program provides health care services to elderly individuals who qualify for a nursing home level of care and can safely remain in the community with PACE services. This positionwill generally evaluate and enforce compliance of clinical outcomes and quality goals in the PACE program and will work collaboratively with other units within the division and department, as well as with the contracted PACE Organizations, and sister agencies.
What you’ll do:

• Review participant eligibility determinations for accuracy;
• Assist with comprehensive reviews of operations, quality of care, and compliance of the PACE Organizations using information in the Electronic Health Record and other data reporting systems;
• Perform the clinical aspect of focused reviews and audits of important PACE functions;
• Provide and coordinate clinical reviews of grievances, appeals, and denials of services
• Regular communication and collaboration with state and federal partners, including the Center for Medicare & Medicaid Services, the Department of Mental Health, and other relevant partners;
• Represent the unit in a variety of workgroups
• Perform policy reviews
• Respond to legislative and external inquiries
• Provide small group training to PACE Organization staff upon implementation related to level of care determinations
• Collaborate with Centers for Medicare & Medicaid Services on PACE reviews
• Develop and maintain a working knowledge of policies/procedures, laws, and regulations and provide accurate interpretation as needed in clinical applications;
• Coordinate with other State agencies on shared population health mandates; and
• Perform other duties as assigned.

This position requires in state travel and occasional overnight stays.

Minimum Requirements:
Licensure as a Registered Nurse and 2-4 years of experience as a Registered Nurse

Preferred Qualifications:
Possession of a current license to practice as a Registered Nurse in the State of Missouri or in accordance with Missouri's Nurse Licensure Compact at the time of appointment. AND A Master's degree in Nursing from an accredited college or university; and, one or more years of professional experience as a Registered Nurse. OR A Bachelor's degree in Nursing from an accredited college or university; and, two or more years of professional experience as a Registered Nurse. OR An Associate's degree in Nursing from an accredited

More reasons to love this position: The State of Missouri offers an excellent benefits package that includes a defined pension plan, generous amounts of leave and holiday time, and eligibility for health insurance coverage. You can view the comprehensive benefit package here. Your total compensation is more than the dollars you receive in your paycheck. To help demonstrate the value of working for the State of Missouri, we have created an interactive Total Compensation Calculator. This tool provides a comprehensive view of benefits and more that are offered to prospective employees. The Total Compensation Calculator and other applicants resources can be found here.

If you have questions about this position please contact: Amanda Clutter at Amanda.Clutter@dss.mo.gov. If you experience accessibility issues while applying, please contact Courtney Hall at Courtney.A.Hall@dss.mo.gov or call 573-751-4244.

Recruitment Area: All eligible applicants.

Application Deadline: April 21, 2022

The State of Missouri is an equal opportunity employer.
We celebrate diversity and are committed to creating an inclusive environment for all employees.