APPROXIMATE ANNUAL SALARY -
$48,086.64 to
$71,514.00
PAY GRADE: 36
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.
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Health Care Coordinators perform professional work related to program operations and auditing providers to ensure compliance with program policies and regulations. Assess potential client needs for case management services using assessment tools to identify social service and/or medical needs; participate in periodic reviews of facilities providing care to Medicaid eligible clients to validate and ensure adequacy of services and resident care. Review health care providers and fiscal agents to ensure clients are receiving appropriate services and payment is correct for services received, process payment authorization requests from providers to ensure the requested service, treatment, equipment or supplies are medically necessary and in compliance with Medicaid criteria prior to approving or denying requests. Review records from the fiscal agent, providers, clients and computer generated reports in order to identify abuse and potential fraud and to ensure claims were paid properly by the fiscal agent. Explain proper billing procedures to contract providers selected by the client; monitor the quality of care given by the provider to clients; and submit billings for services provided to the fiscal agent for payment.
Incumbents perform the full range of duties described above. In addition, incumbents at this level may intermittently serve as the project lead of a case management team, function as coordinator of a specifically assigned portion of a program, and assist in training other Health care Coordinators and providers. This is the journey level of the series.
This position is located within the Aging and Disability Services Division (ADSD) of Health and Human Services, in Reno, NV. ADSD provides an atmosphere of innovative thinking, teamwork, friendly co-workers, and is a great place to work. The mission of the Aging and Disability Services Division is to provide leadership and advocacy in the planning, development and delivery of a high quality, comprehensive support service system across the lifespan to allow all of Nevada's elders, children and adults with disabilities or special health care needs, to live independent, meaningful and dignified lives to the greatest extent possible.
The incumbent will be primarily responsible for providing case management for recipients in the Home and Community Based Waiver (HCBW) for Persons with Physical Disabilities. The incumbent must be able to determine if an individual meets the criteria for placement on the waiver. The waiver provides personal and in home supportive services to assist the recipient to remain in a community setting or to return home if institutionalized.
The incumbent will also provide case management through other Medicaid waivers, Personal Assistance Services (PAS) and the Community Service Options Program for the Elderly (COPE).
The incumbent will be primarily responsible for providing case management for recipients in the HCBW for Persons with Physical Disabilities. The incumbent must be able to determine if an individual meets the criteria for placement on the waiver. The waiver provides personal and in home supportive services to assist the recipient to remain in a community setting or to return home if institutionalized.
The incumbent will also provide case management through other Medicaid waivers, Personal Assistance Services (PAS) and COPE programs.
This position requires frequent travel throughout Carson City, Reno, Sparks and Rural Nevada.
In order to be qualified, you must meet the following requirements:
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Licensure as a Registered Nurse and one year of professional experience providing case management services in a social or health related field; OR one year of experience as a Health Care Coordinator I - Nurse in Nevada State service; OR licensure and an equivalent combination of education and experience. |
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A pre-employment criminal history check and fingerprinting are required. Persons offered employment in this position will be required to pay for fingerprinting. |
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Professional licensure as a registered nurse issued by the appropriate licensing board in the State of Nevada is required at the time of appointment and as a condition of continuing employment. |
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A valid driver's license is required at the time of appointment and as a condition of continuing employment.
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This position requires the incumbent to travel over a wide geographic area, either by motor vehicle or air travel, including commuter planes. |
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Travel at least 75% of the time is required. |
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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. |
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