HP has acquired EDS, creating a leading global IT provider with the industry's best portfolio of products and services. Which means we're stronger than ever. So if you're looking for opportunities with an industry leader, this is an ideal time to join our team. Together we'll move the world in ways never before possible.

Job Number: 2446678

Careers with momentum

From your very first day at HP, you'll notice it-we do things differently around here. You'll be challenged to lead from day one, and rewarded when you do. Because we're in over 170 countries around the world, your work will have a real impact on the lives of people everywhere. We're developing truly remarkable technologies like hardware that thinks for itself and nanotechnology applications that are years ahead of the competition. So bring your passion to HP; together there's no telling what we can achieve.

HP is a leading global provider of products, technologies, solutions and services to consumers and business. The company's offerings span IT infrastructure, personal computing and access devices, global services, and imaging and printing. Our $4 billion annual R&D investment fuels the invention of products, solutions and new technologies so we can better serve customers and enter new markets. We invent, engineer and deliver technology solutions that drive business value, create social value and improve the lives of our customers.

Job Description:

Under minimal direction, provide nursing expertise to staff, management, and customers within a health care environment. Acts as liaison to customers, providers, and recipients by resolving problems and clarifying medical and health care issues. Recommends and promotes beneficial changes to customer programs to promote access to quality care and control of benefit packages. Assist in adjudication of medically complicated claims; participate in customer's policy development. Provides assistance in drafting provider manuals, bulletins, and revisions to promote publication. Conduct on-site and/or desktop reviews of providers and recipients to ensure quality of care and appropriateness of service based on current standards of care. Assist in claims and hospital adjudication committees providing direction and interpretation of state policy. Assist with organized healthcare groups or associations on various medical issues related to the State's medical program. This nurse will be part of the SURS utilization and review team. The team has responsibility for using decision support tools to analyze claims data, practices, and patterns. The SURS team is responsible for conducting routine and special reviews of Medicaid providers and consumers to assure compliance with Medicaid policies and procedures and to detect fraud and abuse. If fraud is suspected, the SURS team will work closely with the Medicaid fraud control units at the attorney general's office. Nurses will initiate overpayment recoveries on cases involving over utilization. Must be open to use of technology as the decision support system is very powerful and on a PC based application.

Job Essential Functions:

Position Prerequisites:

Bachelor's degree or equivalent experience or combination of education and experience
Minimum of two years Medicaid experience or other health care experience
Wisconsin RN or LVN certification
Demonstrated strong writing skills
Experience in fraud and abuse preferred
Valid drivers license

**TO APPLY FOR THIS POSITION**

1.        Go to the following link: http://www.edscareers.com

2.        Select and click on link “Search for Jobs”

3.        Enter requisition number 2446678 the “Keywords” field

4.        Apply for the position

Thank you for your interest!

*This position is not one for which the employer will sponsor an individual for employment visa status or pay relocation assistance.