Assist with investigative, analytical and consultative work at a professional level for DVHA involving health insurance and health care delivery systems
Identify unusual beneficiary and provider utilization patterns including procedural deficiencies in the reporting and claiming of reimbursement for services
Ensure services provided are medically necessary
Perform duties under the direction of the Special Investigations Unit Manager

Possession of (or eligible for) licensure as a Registered Nurse (RN) in Vermont OR eligible to practice in the state of Vermont via a multi-state license
Three (3) years or more of professional nursing experience in an acute care hospital, health insurance carrier, or within a community health setting
Bachelor of Science in Nursing (BSN) preferred

80% State paid medical premium and a dental plan at no cost for employees and their families
Work/Life balance: 11 paid holidays each year and a generous leave plan
State Paid Family and Medical Leave Insurance (FMLI)
Two ways to save for your retirement: A State defined benefit pension plan and a deferred compensation 457(b) plan
Tuition Reimbursement
Flexible spending healthcare and childcare reimbursement accounts
Low cost group life insurance
Incentive-based Wellness Program
Qualified Employer for Public Service Student Loan Forgiveness Program

Nurse Auditor

About this role