Nurse Consultant (General) (40 Hour) Hybrid #250827-5927FP-001

Introduction
The State of Connecticut , Department of Social Services (DSS) is recruiting a Nurse Consultant to work in the Audit Division in our Central Office, located in Hartford, CT.


About Us
The Audit Division ensures compliance, efficiency, and accountability within federal and state programs administered by the Department by detecting and preventing mismanagement, waste and program abuse and ensuring that state and federal dollars are spent appropriately, responsibly, and in accordance with applicable laws and regulations.


The Role

• Performs federally mandated audits of medical and health care providers that are paid through the various medical assistance programs administered by the Department;
• Reviews medical provider activities, audits claims, identifies overpayments, and educates providers on program integrity issues;
• Provides support and assistance to the Department Special Investigations Division in the ongoing effort to combat fraud and abuse;
• Performs data analytics to identify aberrant billing activity and pursues collection of such overpayments; and
• Substantiates whether complaints received from various sources are valid and determines the proper disposition of the complaint including conducting an audit or forwarding to the Department’s Special Investigations Division.
  
  
  

What’s In It For You
Visit our new State Employee Benefits Overview page!

• Professional growth and paid professional development opportunities.
• A healthy work-life balance to all employees.
• State of Connecticut is an eligible Public Service Loan Forgiveness employer, meaning you may be eligible to have qualifying student loan forgiveness after 10 years of service. Click here for more information.
  
  
  

Discover The Opportunity To

• Engage in a rewarding career
• Assist our employees so they can achieve success
• Make a difference in the public sector
• Work together in a collaborative team environment
  
  
  

Selection Plan
For Those Who Hold a Rn License In a State Other Than Connecticut And Wish To Apply For a Connecticut License, Please

• Review the eligibility and documentation requirements for CT license by endorsement of an out-of-state license;
• Complete a CT DPH online application online (expand the ‘Public Health Practitioners’ grouping, select ‘Registered Nurse’ and then ‘Start’;
• Request verification of your out-of-state license(s) electronically through the National Council of State Boards of Nursing’s : Nursys® System. To send verification of your license(s) to CT, read and agree to the terms, enter your biographic information, select your license type and select ‘SEARCH’. Review the results and select the ‘Next’ button. Check the box next to ‘Connecticut’ and complete the transaction. Once the transaction is completed, you will receive a confirmation email from Nursys and the verification will be available to the DPH. Note that PA and MI verifications are not provided through Nursys. Please contact those state boards for information on obtaining verification.
  
  
  

For Assistance In Applying
Check out our Applicant Tips on How to Apply ! Need more resources? Visit our Applicant Reference Library for additional support throughout the recruitment process.


Before You Apply

• Meet Minimum Qualifications: Ensure you meet the Minimum Qualifications listed on the job opening by the job closing date. You must specify your qualifications on your application. The minimum experience and training requirements listed must be met by the close date on the job opening, unless otherwise specified.
• Educational Credits: List your earned credits and degrees from accredited institutions accurately on your application. To receive educational credits towards qualification, the institution must be accredited. If the institution of higher learning is located outside of the U.S., you are responsible for providing documentation from a recognized USA accrediting service which specializes in determining foreign education equivalencies to the contact listed below.
• Resume Policy: Per Public Act 21-69 , resumes are not accepted during the initial application process. As the recruitment process progresses, candidates may be required to submit additional documentation to support their qualification(s) for this position. This documentation may include: a cover letter, resume, transcripts, diplomas, performance reviews, attendance records, supervisory references, licensure, etc., at the request and discretion of the hiring agency.
• Preferred Shift/Location: Select all location(s) and shift(s) you are willing to work on your application. Failure to do so may result in not being considered for vacancies in that specific location or shift.
• Timely Submission: All application materials must be received by the job posting deadline. You will be unable to make revisions once you officially submit your application to the State. Late submissions are rarely accepted, with exceptions only for documented events that incapacitate individuals during the entire duration of the job posting. Request exceptions by emailing DAS.SHRM@ct.gov .
• Salary Calculations: For current state employees, salary calculations are not necessarily comparable from one of the three branches of state government (i.e., Executive, Legislative, Judicial) to the other.
• Note: The only way to apply to this posting is via the ‘Apply’ or ‘Apply Online’ buttons on the official State of Connecticut Online Employment Center job posting.
  
  
  

After You Apply

• Referral Questions: This posting may require completion of additional Referral Questions (RQs), which must be completed by the questionnaire’s expiration date. If requested, RQs can be accessed via an email sent to you after the job close date or by visiting your JobAps Personal Status Board (Certification Questionnaires section).
• Prepare For An Interview: Interviews are limited to those whose experience and training are most aligned with the role. To prepare, review this helpful Interview Preparation Guide to make the best impression!
• Stay connected! Log in daily to your JobAps Personal Status Board to track your status and check email (including spam/junk folders) for updates and tasks.
• The immediate vacancy is listed above, however, applications to this recruitment may be used for future vacancies in this job class.
• Note: This position will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules. Candidates who are offered and accept a position with the State of Connecticut are bound by the State Code of Ethics for Public Officials and State employees, available at www.ct.gov/ethics .
  
  
  

QUESTIONS? WE’RE HERE TO HELP:
Due to high volume, we are unable to confirm receipt or provide status updates directly. For recruitment updates, please check your Personal Status Board and review our Frequently Asked Questions. If you have additional questions about the recruitment process, reach out to at Christopher.Lavallee @ct.gov .

Join the State of Connecticut and take your next career step with confidence!


PURPOSE OF JOB CLASS (NATURE OF WORK)
In the Departments of Public Health, Children and Families, Correction, Developmental Services, Mental Health and Addiction Services, Social Services and the Office of Early Childhood this class is accountable for applying professional nursing knowledge in the enforcement, inspection, licensure, consultation and implementation or assessment of the nursing service component of health care programs and facilities.

In the Office of the State Treasurer, Second Injury and Assurance Fund this class is responsible for managing, directing, implementing and monitoring programs involving medical cost containment and disability management relating to occupational injuries and loss control matters.


EXAMPLES OF DUTIES

• Implements, coordinates, and evaluates activities of assigned programs or health care services;
• Maintains active liaison with and serves as nursing consultant to other sections, divisions, health care providers and public;
• Assesses safety and quality of client care provided;
• Assesses compliance of health insurance companies with various state statutes, regulations and guidelines;
• Provides consultation and reviews, evaluates and authorizes requests for medical placement services or equipment for clients covered under medical assistance programs;
• Evaluates requests from health care providers asking to be included in medical assistance programs and offers consultation regarding interpretation of programs, policies and regulations;
• May inspect and evaluate health care and psychiatric facilities for compliance with state and federal regulations including licensure and certification laws;
• Performs related duties as required.
  
  
  

KNOWLEDGE, SKILL AND ABILITY

• Considerable knowledge of
• standards of care and service delivery in community based nursing agencies, licensed home health agencies, health care facilities and institutions;
• relevant state and federal laws, statutes and regulations;
• principles and practices of nursing care administration and education for a variety of specialties with varied settings;
• principles and practices pertinent to community processes;
• Knowledge of
• state, federal and local health agencies and programs;
• nursing education and skill in techniques of teaching;
• Considerable
• interpersonal skills;
• oral and written communication skills;
• Ability to
• plan, implement and evaluate programs;
• collect and analyze data.
  
  

Minimum Qualifications - General Experience
Four (4) years of experience as a Registered Nurse in a position involving supervision, consultation, education or administration.


Note

• Administrative capacity is interpreted as having managerial responsibility in setting and implementing policies, carrying out program planning, and evaluating and coordinating special projects, etc. in the area specified in the appropriate parenthetical title.
• Consultative capacity is interpreted as the providing of professional expert nursing advice to other than subordinate staff on major programmatic issues in the area specified in the appropriate parenthetical title.
• Educational capacity is interpreted as experience in a full time professional educational position instructing professional nurses in a formalized program or teaching students in an undergraduate or graduate nursing program in the area specified in the appropriate parenthetical title.
• Supervisory capacity is interpreted as having administrative supervision of registered nurses or other professional staff.
  
  
  

Minimum Qualifications - Special Experience
Two (2) years of the General Experience must have been in a public health nursing program, home health care agency, community health care setting, or in a hospital.


Minimum Qualifications - Substitutions Allowed

• A Bachelor's degree in nursing may be substituted for one (1) year of the General Experience.
• A Master's degree in health services administration, nursing or public health may be substituted for one (1) additional year of the General Experience.
  
  
  

Preferred Qualifications

• Experience with regulation and performance compliance in the healthcare setting. Experience implementing, coordinating, and evaluating activities of assigned programs or health care services.
• Experience assessing compliance of health insurance companies with various state statutes, regulations and guidelines.
  
  
  

Special Requirements

• Incumbents in this class must possess and retain a current license as a Registered Nurse in Connecticut.
• Incumbents in this class may be required to possess certification as an Insurance Rehabilitation Specialist or be eligible for certification as an Insurance Rehabilitation Specialist.
• Incumbents in this class may be required to travel.
• Incumbents in this class may be required to possess and retain a valid Motor Vehicle Operator’s license.
  
  
  
  

Conclusion

AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER
The State of Connecticut is an equal opportunity/affirmative action employer and strongly encourages the applications of women, minorities, and persons with disabilities.


ACKNOWLEDGEMENT
As defined by Sec. 5-196 of the Connecticut General Statutes, a job class is a position or group of positions that share general characteristics and are categorized under a single title for administrative purposes. As such, a job class is not meant to be all-inclusive of every task and/or responsibility.