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.

Position Prerequisites:
*   Bachelor's degree or equivalent work experience or combination of education and experience
*   Minimum of two years Medicaid experience or other health care experience preferred
*   Kansas RN certification
*   Demonstrates writing skills Essential Functions:
*   Ability to make claims payment determination
*   Strong oral/written communication skills
*   Ability to read, understand, and interpret complex regulatory and procedural documents
*   PC skills
*   Time management and organizational skills
*   Ability to work independently without frequent supervision
*   Strong analytical skills
*   Ability to successfully interact with other departments

Position Overview: Under minimal direction, provide nursing expertise to staff, management and customer within a health care account. Act as liaison to customers, providers, and recipients by resolving problems and clarifying medical and healthcare issues. Recommend and promote 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. Provide assistance in drafting provider manuals, bulletins, and revisions to promote publication. Assist with organized healthcare groups and associations on various medical issues related to the State's medical program. This nurse will be part of the Prior Authorization team. The team has the responsibility for the following: to review, assess, and pre- approve selected non-emergency medical services prior to the actual delivery. The nurse is to help with cost containment and utilization review measures to make payment for only those treatments and services that are medically necessary, appropriate, and cost effective. The nurse provides support to the case management functions by accepting treatment plans as a form of prior authorization. This is a salaried position and other duties may be assigned as required.

TO APPLY TO THIS POSITION:

Please go to Edscareers.com

Click "search for jobs" enter 2432889 as the "keyword" and click search. Click on the job title and scroll down to "apply."