For more information on benefit and retirement programs, please see the sections below.
In order to receive consideration, applicants must indicate their availability for any work type, travel, and location requirements listed.

Under direction, the Compliance Specialist - Registered Nurse provides medical expertise for the Division of Industrial Relations, Workers' Compensation Section. Incumbents monitor compliance and detect violations of State laws and/or regulations by medical providers, insurance carriers, Third Party Administrators (TPAs), medical billing vendors, employers, and in Permanent Partial Disability (PPD) reports; supervise lower-level Compliance/Audit Investigators; and oversee the Medical Unit in their assigned regions.

Under direction of the Compliance Coordinator-Registered Nurse, the Compliance Specialist-Registered Nurse maintains Treating and Rating Panels of Physicians and Chiropractors as well as insurers' provider lists as directed by supervisor; supervises subordinate Medical Unit staff in the Las Vegas office; verifies medical providers and claim file records are complete and appropriately documented; ensures authorized services correlate with services provided and billed; and reviews medical records.

The incumbent conducts interviews with stakeholders; documents findings and deficiencies appropriately; makes determinations regarding program violations including recommendations for administrative actions including fines; gathers data and assists with revising the Medical Fee Schedule; provides advice and assistance in preparation of medical documentation and testimony for hearings/appeals; ensures compliance with standards of health care; trains internal and external stakeholders; investigates and recommends warning, suspending or removing provider from provider panels; verifies providers and fiscal agents are in compliance with division policies and procedures; and conducts audits as assigned. The incumbent manages PPD reports and will review and identify potential errors; refer and facilitate Quality Assurance Panel meetings; resolves medical billing disputes, writing formal determinations as needed; and performs related duties as assigned. **Please ensure your application reflects your current nursing license information. This should be included in the "license" section of your application.** The State of Nevada is committed to Equal Employment Opportunity/Affirmative Action in recruitment of its employees and does not discriminate on the basis of race, color, national origin, religion or belief, age, disability, sex, sexual orientation, gender identity or expression, pregnancy, domestic partnership, genetic information (GINA), or compensation and/or wages. ***THIS RECRUITMENT MAY CLOSE AT ANY TIME BASED ON THE AMOUNT OF APPLICATIONS RECEIVED. QUALIFIED APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE.***

In order to be qualified, you must meet the following requirements: