APPROXIMATE ANNUAL SALARY -
$53,598.96 to
$79,719.84
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 Department of Health and Human Services, Aging and Disability Services Division (ADSD) - Community Based Care in Reno, NV. ADSD provides an atmosphere of innovative thinking, teamwork, friendly co-workers, and provides a positive working environment. The mission of ADSD 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.
This position will act as a project lead; training newly hired staff; assist the intake team(s) in completing initial assessments; provide case management to recipients residing in independent home visits with recipients in their homes and in our group home settings which include completing social health assessments and level of care screenings; and conduct recipient contacts and reassessments as required. Additionally, this position will assist in providing nursing consultation and recommendations to Community Based Care staff, which includes reviewing medical records for eligibility purposes. This position may also assist with case file reviews, preparing necessary forms, reports, and inputting data.
Nevada offers sunshine and recreational opportunities abound including golfing, biking, off-roading, hiking, skiing, and fishing. Nevada's beautiful landscape and thriving economy are just a few of the 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 each year; and accrual of 3 weeks of annual leave and 3 weeks of sick leave each year. Aging and Disability Services Division 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 identity and expression.
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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A State of Nevada/FBI background check will be required of the selected applicant. |
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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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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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1) Describe your experience providing case management services in a social or health related field including where it was gained.
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