Job Description
Job Description
Introduction
Are you a passionate healthcare professional looking to make a tangible impact on Medicaid and Children's Health Insurance Programs (HUSKY Health)? We will empower you to lead groundbreaking healthcare initiatives that drive program quality, enhance community health, and promote social justice. We believe in fostering strong partnerships and open communication, and we are committed to shaping policies that ensure equity and inclusivity. Are you ready to join us in leveraging your clinical expertise and data-driven decision-making skills to shape the future of healthcare in Connecticut?
Unique Opportunity
We Have An Outstanding Opportunity For a Nurse Consultant To Join Our Department Of Social Services (DSS). In The Division Of Health Services, Integrated Care Unit-Medical Administration, You Will Coordinate Administrative Service Contracting For HUSKY Health Medicaid And CHIP, Making a Direct Impact On Community Health And Well-being. As a Nurse Consultant, You Will Be Tasked With
- Leading program quality, ensuring contract compliance for the medical ASO contract.
- Monitoring clinical contractual obligations, ensuring compliance with state and federal laws, regulations, and quality assurance activities.
- Serving as a liaison between department sections, healthcare providers, and the public to enhance communication and collaboration.
- Developing healthcare program goals, evaluating health service outcomes, and applying statistical data for data-driven decision-making.
- Leading value-based purchasing initiatives, addressing social justice issues in data science, and presenting program initiatives at internal and public meetings.
Benefits
The State of Connecticut prioritizes the well-being of our employees and recognize the importance of maintaining a harmonious work-life balance. Alongside competitive compensation, we provide a range of benefits, including medical, dental, and vision insurance, retirement plans, paid time off, and professional development opportunities.
- Visit our new State Employee Benefits Overview page!
- Work for a Forbes top company: 'Forbes' State of Connecticut Ranked One of the Best Employers of 2023 - State of CT Receives National Recognition for Offering Job Growth, Competitive Benefits, and Flexible Schedule.
To excel in this role, you'll bring a deep understanding of Connecticut’s Medicaid and Children’s Health Insurance Program (HUSKY Health), with the ability to interpret federal and state policies to ensure effective implementation. You will collaborate closely with internal teams and external stakeholders to build strong partnerships, fostering open communication and shared goals. Your expertise in applying data-driven insights and healthcare standards will support strategic decision-making and continuous improvement. A commitment to addressing social justice in healthcare will be central to shaping policies that promote equity and inclusivity. Working together, we'll ensure that every project is managed smoothly, meeting tight deadlines while maintaining a focus on quality and impact.
Selection Plan
- Please visit our ' Applicant Tips on How to Apply ' page or view our tutorial .
- The minimum experience and training requirements must be met by the close date on the job opening, unless otherwise specified.
- Although applicants will receive correspondence via email, as a backup they are also encouraged to sign on to their Personal Status Board on a daily basis to monitor their status, view all emailed notices and complete tasks required in the recruitment process.
- In order to comply with Public Act 21-69, the State of Connecticut is no longer asking for resumes during the initial application process.
- This posting may require completion of additional referral questions (RQs). You can access these RQs via an email that will be sent to you after the posting's closing date or by visiting your JobAps Personal Status Board (Certification Questionnaires section). Your responses to these RQs must be submitted by the question's expiration date. Please regularly check your email and JobAps Personal Status Board for notifications. Please check your SPAM and/or Junk folders on a daily basis in the event an email provider places auto-notification emails in a user's spam.
- Note: At any point during the recruitment process, applicants may be required to submit additional documentation which support their qualification(s) for this position. These documents may include: a cover letter, resume, transcripts, diplomas, performance reviews, attendance records, supervisory references, licensure, etc., at the discretion of the hiring agency. Applicants must meet the minimum qualifications as indicated to apply for this position.
- Should you have questions pertaining to this recruitment, please contact Liz Pinette at elizabeth.pinette@ct.gov .
- This position will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules.
- The immediate vacancy is listed above, however, applications to this recruitment may be used for future vacancies in this job class.
- All application materials must be received by the recruiting agency by the time specified on the job opening for the position for which you are applying. Late applications may not be submitted and will not be considered. Exceptions are rare and limited to documented events that incapacitate a candidate during the entire duration of the job posting time period. It is the candidate’s obligation and responsibility to request an exception and provide a legally recognized justification to accommodate such exception. Requests should be made to DAS.SHRM@ct.gov .
- 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.
- Read through this helpful link to prepare for your interview .
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 professional 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 and/or understanding of the CT Medicaid and Children’s Health Insurance program (CHIP) known as HUSKY Health.
- Experience in planning healthcare program goals, objectives, and evaluation of health service achievements.
- Experience in establishing connections, building community relationships, and serving as a liaison between department sections, divisions, healthcare providers, and the public.
- Experience with national healthcare standards and measures such as Healthcare Effectiveness Data and Information Set (HEDIS), National Quality Forum (NQF), and Adult and Child Heath Quality (Core) Measures.
- Experience interpreting federal and state statute, regulation, and policy to ensure Medicaid and CHIP policy is implemented appropriately.
- Experience in utilizing and interpreting statistical data and other science-based tools to make data-driven decisions, with an understanding of under-represented voices in various data sets.
- Experience with addressing race, gender, and social justice aspects of data science and its impact on community health.
- Experience with fast-paced work environment, managing short deadlines, and quickly turning around documents; capable of handling multiple projects simultaneously, often requiring immediate attention.
- Experience in developing value-based purchasing (VBP) initiatives and clinical projects.
- Experience working independently to represent program initiatives and present data at both public and internal departmental meetings.
Special Requirements
- Incumbents in this class must possess and retain a current license as a registered professional 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.
Job Tags
Full time, Contract work, Local area, Immediate start, Flexible hours,