68055652 - REGISTERED NURSING CONSULTANT

Requisition No: 847689 

Agency: Agency for Health Care Administration

Working Title: 68055652 - REGISTERED NURSING CONSULTANT

 Pay Plan: Career Service

Position Number: 68055652 

Salary:  $1,949.64 - $2,720.51 Biweekly 

Posting Closing Date: 03/11/2025 

Total Compensation Estimator Tool

Position Overview:

This is a full-time Registered Nursing Consultant position within the Bureau of Medicaid Program Integrity (MPI), and is budgeted for 40 hours per week, Monday-Friday 8 a.m. to 5 p.m. 

 

This position is anticipated to be filled at the salary range of $1,949.64 - $2,720.51 Biweekly ($50,690.64 to $70,733.26 yearly), based upon the selected candidate's qualifications and experience.

 

This position may involve travel-related activities from 1-10%.

Successful completion of a criminal background investigation is a condition of employment.

 

This is an opportunity for a Registered Nurse (RN) or an Advanced Practice Registered Nurse (APRN) working in Tallahassee within the Agency’s Bureau of Medicaid Program Integrity (MPI). 

MPI serves as the primary organizational unit within the Agency for the purposes of prevention, detection, and recoupment/enforcement related to Medicaid program oversight, as well as the lead unit for compliance with contractual and statutory requirements related to fraud and abuse activities. 

 

This is a highly responsible professional and clinical position.

The selected candidate is responsible for providing professional medical consultation and technical assistance to investigators, auditors, analysts, and administrators. 

The selected candidate must be a Florida licensed Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN).

 

The selected candidate will assist in a variety of operational, administrative, and clinical functions.  Included in these functions are activities such as: 

 

•Serving as a consultant to the management team on clinically related topics and special projects.

•Utilizing clinical knowledge and experience in interpreting medical records and comparing service documentation to submitted claims data.

•Performing medical reviews of documentation for compliance with guidelines set forth in applicable rules and Medicaid coverage and limitations policies.

•Applying knowledge of medical terminology, diagnostic and procedure coding, and Diagnosis Related Groups.

•Managing a caseload of overpayment recovery audits.

•Assuring completeness and accuracy of medical records analyses and other documentation reviews.

•Conducting prepayment reviews of Medicaid providers.

•Conducting on-site investigative reviews and interviews of Medicaid providers and recipients.

•Serving as an expert witness in administrative hearings.

•Providing training to other MPI staff on medical terminology and clinical documentation reviews.

•Communicating technical and clinical information effectively.

•Preparing accurately written and documented findings, conclusions, summary reports, and recommendations.

•Establishing and maintaining effective working relationships with other team members and stakeho