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Nevada Employee Action and Timekeeping System
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State of Nevada Announces
An Open Competitive Recruitment for:
APPROXIMATE ANNUAL SALARY -  $73,309.68 to  $109,640.88  PAY GRADE: 38
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.
Work Type: A Permanent, full time vacancy
Department: Business and Industry
Division: Industrial Relations
Job Class Code: 10.248
Announcement Number: 47793
Open to all qualified persons.
Posted 06/18/2024
Close Date: 07/18/2024
   Phone: (775)684-0151
   Email: aornellas@admin.nv.gov
Applications accepted for another 5 Days 23 Hrs 35 Mins
The Position
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.
This position may be located in Carson City or Las Vegas, based upon the most qualified candidate. The Compliance Coordinator Registered Nurse manages and supervises subordinate Medical Unit staff statewide, providing medical expertise for the Division of Industrial Relations, Workers' Compensation Section. This position monitors compliance, detecting violations of State law by medical providers, insurers, third-party administrators, medical billing vendors, employers and in Permanent Partial Disability (PPD) reports. The position ensures both the Treating and Rating panels are developed and updated per statutory requirements; maintains the Treating and Rating Panels of Physicians and Chiropractic Physicians; approves and facilitates the posting of insurers' provider lists and other statutory requirements; verifies that medical providers and claim file records are complete and appropriately documented and authorized services correlate with services provided and billed; conducts interviews with stakeholders; documents findings and deficiencies appropriately; makes determinations regarding program violations including recommendations for administrative actions including fines; gathers data; revises the Medical Fee Schedule annually; 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, suspension, or removal of provider from provider panels; verifies that providers and other stakeholders comply with division policies and procedures; conducts audits as assigned; coordinates and facilitates quarterly Quality Assurance Panel meetings; ensures legislative deadlines are met for Medical Unit projects; reviews and identifies errors on PPD reports and facilitates PPD Review Panel meetings; and approves and resolves medical billing disputes, writing formal determinations as needed.
The State of Nevada is an equal opportunity employer dedicated to building diverse, inclusive, and innovative work environments with employees who reflect our communities and enthusiastically serve them. All applicants are considered without regard to 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 WITHOUT FURTHER NOTICE DEPENDING ON THE NUMBER OF APPLICATIONS RECEIVED. APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE***

To Qualify:
In order to be qualified, you must meet the following requirements:
Education and Experience (Minimum Qualifications)
    Current license to practice as a Registered Nurse and three years of professional nursing experience, two years of which included professional experience in workers' compensation, occupational health, or case management; OR one year of experience as a Compliance Specialist - Registered Nurse in Nevada State service; OR an equivalent combination of education and experience.
Special Requirements
    A valid driver's license is required at the time of appointment and as a condition of continuing employment.
The Examination
Application Evaluation Exam
The exam will consist of an application evaluation. It is essential that applications include detailed information with time frames regarding education and experience. The most qualified applicants will be contacted by the hiring agency for interview. The hiring agency may require specific skills related testing as part of the interviewing process.
The following additional questions are part of this Recruitment
1) Describe your worker's compensation experience.
2) Describe your compliance investigations experience.
3) Describe your medical billing experience.
For more information about state employment, visit the following:
Division of Human Resource Management: http://hr.nv.gov
Public Employees Retirement System: http://www.nvpers.org
Public Employees Benefits Program: http://pebp.state.nv.us
More Benefits Information: http://nvjobs.nv.gov/Applicants/EB
Help us reach qualified candidates! Refer a friend by clicking here:
Direct Inquiries or Correspondence to:
Division of Human Resource Management
Northern Nevada
515 East Musser Street,
First Floor
Carson City, Nevada 89701-4204

TDD for the Hearing Impaired (800) 326-6868
Division of Human Resource Management
Southern Nevada
7251 Amigo St,
Suite 120
Las Vegas, NV 89119

TDD for the Hearing Impaired (800) 326-6868
To begin the application process, click on the Apply button. Click Cancel to return to the previous page.

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