Job Location: This position will be located at 920 Wildwood, Jefferson City MO 65109
Why you’ll love this position:The Central Office Medical Review Unit (COMRU) is responsible for reviewing assessments to determine individual eligibility to enter a Medicaid certified bed in nursing facilities. The review includes a determination of Level of Care eligibility and referrals to the Department of Mental Health when an individual is determined to have a diagnosis of a severe mental illness or developmental disability for a Level 2 screening. This professional position coordinates a determination using state and federal regulations as to whether or not an individual's medical needs qualifies them for admission to a Medicaid certified bed. This position may qualify for remote work location after 3-4 months of training in the office, with at least one day in the office per business week.
- Review level of care applications, including medical records submitted to determine if the individual’s medical needs meet the state regulatory requirements for admission into a state certified Medicaid bed. Department of Mental Health.
- Determine if the individual has a qualifying mental health condition outlined in federal regulation, requiring a secondary screening by the state mental health authority (Department of Mental Health) prior to admission in the facility.
- Communicate with applicants/submitters regarding corrections or additional information needed.
- Work as a team member to help with backup assistance for other job duties in the unit to ensure timely review and determinations are made.
- Receive and prepare Sunshine Requests for records maintained by the unit.
- Provide at time information and education to persons submitting an application, including hospital social workers and clinical staff.
Minimum Qualifications: - Ability to move from one task to another in a fast-paced environment
- Strong computer skills with the ability to learn new programs
- Excellent oral and written communication skills and customer service skills with skilled nursing facilities, hospitals, and other entities is an essential component of this position.
- Candidates must submit official college transcripts. Candidates must meet the qualifications for the classification of a Registered Nurse (available at https://oa2.mo.gov/personnel/careers/direct-health-services/nursing
Lack of post-secondary education will not be used as the sole basis denying consideration to any applicant.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. 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 applicant resources can be found here .
