| Purpose: |
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Under general direction, provides utilization, case and quality management for the Medical Assistance Program (MAP). |
| Duties, Functions and Responsibilities: |
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Essential duties and functions, pursuant to the Americans with Disabilities Act, may include the following. Other related duties may be assigned.
- Responsible for development and performance of quality management activities.
- Responsible for data analysis and reporting of all activities.
- Responsible for development and performance of inpatient and outpatient case management and disease management activities.
- Backup for pre-authorization of pharmacy services
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| Responsibilities - Supervisor and/or Leadership Exercised: |
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None.
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| Knowledge, Skills, and Abilities: |
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Must possess required knowledge, skills, abilities, and experience and be able to explain and demonstrate, with or without reasonable accommodations, that the essential functions of the job can be performed.
- Knowledge of utilization management, case management, quality management, and/or acute care.
- Knowledge of various computer software (word processing, database management, claims payment system).
- Skill in oral and written communication.
- Skill in establishing and maintaining good working relationships with other city employees and the public
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| Minimum Qualifications: |
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- Graduation from an accredited school of nursing plus three (3) years of experience in a hospital or public health nursing
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| Licenses and Certifications Required: |
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- Licensed as a Registered Nurse in the State of Texas.
- Must have current healthcare provider Cardiopulmonary Resuscitation (CPR) course completion card and will be required to maintain a current certification during employment.
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