Registered Nurse

Job Title: Registered Nurse

Location: Indianapolis, IN 46204

Duration: 06 Months to Long term

Shift: Standard First

Job Description.

• Oversee the medical frail identification and verification process across all Indiana Medicaid programs.
• Review and validate MCO medically frail determinations for accuracy, completeness, and compliance.
• Ensure determinations reflect clinical judgment, not automatic assignment based solely on diagnosis (e.g. HIV, SUD, chronic conditions).
• Provide final clinical determinations for complex or borderline cases.
• Serve as the program lead for the MARA risk-adjustment tool as it relates to medically frail identification.
• Interpret MARA outputs and integrate them into the medically frail review workflow.
• Collaborate with actuarial and analytics teams to refine MARA parameters and ensure alignment with policy intent.
• Work closely with DFR to ensure accurate eligibility pathways for medically frail members.
• Coordinate with Gainwell on systems configuration, data accuracy, and backend processing.
• Provide clinical consultation to internal teams regarding medically frail criteria, documentation standards, and case resolution.
• Conduct retrospective audits of MCO determinations to ensure compliance with federal and state medically frail requirements.
• Identify patterns of over- and under-designation and implement corrective action plans.
• Ensure the state remains aligned with federal Centers for Medicare & Medicaid Services (CMS) guidelines regarding the "significantly impairs” standard and 12-month look-back periods.
• Perform clinical assessments of member documentation to determine whether functional or behavioral health needs meet medically frail criteria.
• Apply federal definitions, including serious and complex medical conditions, functional impairments, and chronic substance use disorders.
• Document clinical rational or determinations and communicate decisions to MCOs and internal partners.

Required Qualifications:  

• Registered Nurse License
• BLS Certificate

About our Company: -

22nd Century Technologies Inc., (TSCTI) is one the fastest growing healthcare staffing companies in the United States. With presence in all 50 States and 6000+ employees nationwide, we have been providing un parallel healthcare and technology staffing services to Public and Private sectors for over 26 years.

Started as a technology staffing company in 1997, we have significantly expanded our healthcare practice to both Clinical and Non-Clinical staffing, serving various facilities, healthcare organizations and government agencies. Our ISO certified staffing practices and technology driven staffing procedures – from recruitment to onboarding, along with an internal pre-vetted resume database of healthcare professionals, enable us to serve our customers with their immediate staffing needs.
TSCTI has extensive experience providing Physicians, Nurses, Pharmacists and other Allied Health professionals to various states – California, Connecticut, District of Columbia, Florida, Michigan, Minnesota, New Jersey, New York, Texas, Vermont, Virginia to name a few, and Our valued relationships with employees as well as commitment to meet and exceed clients’ expectations through our exemplary employees proves our competency in today’s healthcare staffing industry.

Recognized among “Best Company to Work For” by Forbes, 22nd Century Technologies, Inc., consistently exceeds our clients’ expectations by focusing on their absolute satisfaction with jobs while keeping our employees motivated.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.