APPROXIMATE ANNUAL SALARY -
$49,151.52 to
$72,871.20
PAY GRADE: 34
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.
Applications accepted
until recruitment needs are satisfied
** Qualified individuals are encouraged to apply immediately. Lists of eligible candidates will be established and hiring may occur early in the recruiting process. Recruitment will close without notice when a sufficient number of applications are received or a hiring decision has been made.
The Position
Health Care Coordinators perform professional work related to Medicaid program operations and auditing providers to ensure compliance with program policies and regulations.
Incumbents possess a degree of knowledge and proficiency sufficient to perform work independently with little or no additional training.
This position will perform professional work related to program operations and auditing providers to ensure compliance with program policies and regulations. The incumbent will evaluate individuals referred to the medical services program and provide ongoing case management services to Medicaid eligible clients; evaluate the need for medical services, treatment, equipment and supplies and authorize payment; screen individuals to determine appropriate level of care in nursing homes; review programs to ensure services are being provided in a cost effective manner; participate in program development by providing input on policies and procedures, forms, medical coverage and system enhancements.
Assess potential client needs for case management services using assessment tools to identify social service and/or medical needs; develop and implement plans of care for those determined to be eligible for services; counsel and refer clients to services and/or contract with providers for services; maintain contact with clients through home visits and telephone calls; monitor the quality and cost of services provided to clients; periodically update plans of care; submit payment authorization requests; and maintain case files.
Participate in periodic reviews of facilities providing care to Medicaid eligible clients to validate and ensure adequacy of services and resident care; ensure reimbursement matches the cost of services provided; monitor nursing facility quality indicator reports; screen and assess Medicaid clients regarding discharge to community-based care; review medical records; document findings and deficiencies on appropriate forms; prepare reports of findings and participate in exit conferences; participate in independent professional reviews of providers to determine the quality of care, compliance with patient rights, and appropriateness of placement as assigned.
In order to be qualified, you must meet the following requirements:
Education and Experience (Minimum Qualifications)
Licensure as a Social Worker or professional licensure or certification in a medical specialty applicable to the assignment, 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 in Nevada State service; OR licensure and an equivalent combination of education and experience.
Special Requirements
A pre-employment criminal history check and fingerprinting are required. Persons offered employment in this position will be required to pay for these items.
Professional licensure or certification as a social worker, nurse or in a medical specialty issued by the appropriate licensing board in the State of Nevada at the time of appointment. Incumbents must maintain professional licensure or certification in their specialty as a condition of continuing employment.
This position has a 50% travel requirement.
Requires a valid driver's license or evidence of equivalent mobility at the time of appointment and for continuing employment.
Additional Position Criteria
This position requires current licensure as a Social Worker or Registered Nurse. A copy of your license MUST be attached to your application.
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) Please describe your experience providing case management services in a social or health related field, including where the experience was gained.
