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.
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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 become familiar with Medicaid policies and procedures and receive training in the duties described above. This is the entry level in the series and progression to the journey level may occur upon successful completion of the probationary period, meeting the minimum qualifications, and with the recommendations of the appointing authority.
This vacancy is within the Division of Health Care Financing and Policy - District Office, located in Reno, NV. The incumbent will be underfilling a Health Care Coordinator 2 - Nurse, and will auto-progress to the next level in the series upon meeting the minimum qualifications and upon appointing authority approval. This position assesses and provides care coordination services to disabled children eligible under the Katie Beckett Eligibility Option
as determined by the Division of Welfare and Supportive Services. This position would also conduct provider reviews and or site visits to evaluate for compliance of state and federal regulations or for provider enrollment requirements and report findings within short time constraints to contribute to the health, safety, and welfare of Medicaid recipients. The successful candidate will need to complete certification by the American Association of Nurse Assessment Coordinators (AANAC) as a Resident Assessment Coordinator (RAC-CT) after a period of training. The travel requirements for this position are up to 50%.
Nevada offers sunshine and recreational opportunities including golfing, biking, off-roading, hiking, skiing, and fishing. Nevada's landscape and economy are a few reasons to join the Silver State workforce! Additional benefits include: medical, dental, life and disability insurance programs; participation in the public employees' retirement plan; 11 paid holidays; and accrual of 3 weeks of annual and 3 weeks of sick leave each year. DHCFP is committed to Equal Employment Opportunity/Affirmative Action in recruitment of its employees and does not discriminate on the basis of race, color, national origin, religion or belief, age, disability, sex, sexual orientation, pregnancy, genetic information (GINA), or gender.
In order to be qualified, you must meet the following requirements:
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Licensure as a Registered Nurse. |
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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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A valid driver's license is required at the time of appointment and as a condition of continuing employment. |
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Professional licensure as a registered nurse or certification in a medical specialty 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 copy of your current licensure as a registered nurse MUST be attached to your application. |
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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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