HEALTH CARE COORDINATOR 2 - NURSE
- MEDICAL SERVICES PROGRAM
APPROXIMATE ANNUAL SALARY -
$53,598.96 to
$79,719.84
PAY GRADE: 36
The salary range indicated in this announcement is based on the Employee/Employer retirement compensation schedule. An employer-only option is available at a reduced salary range. Generally, salaries start at the lowest level of a step 1 and increase with each year of service to the highest level of a step 10.
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.
JOB INFORMATION
Work Type: Permanent, full time vacancies as they may occur
in this geographical location.
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 opening is for a Health Care Coordinator 2-RN within the Division of Health Care Financing and Policy (DHCFP) District Office in Las Vegas.
This position requires less than fifty percent of time travelling within the Las Vegas District Office catchment area.
Health Care Coordinators (HCC's) 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 and participate in program development. This position takes the more medically complex cases to ensure safety in the home as opposed to being admitted to a facility. 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 incumbent will obtain and maintain AANAC certification to complete MDS reviews in long term care facilities.
Nevada offers sunshine and recreational opportunities including golfing, biking, off-roading, hiking, skiing, and fishing. Nevada's landscape and activities 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. The State of Nevada 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, gender identity or expression, pregnancy, domestic partnership, genetic information (GINA), or compensation and/or wages. THIS RECRUITMENT MAY CLOSE AT ANY TIME BASED ON THE AMOUNT OF APPLICATIONS RECEIVED. QUALIFIED APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE.
In order to be qualified, you must meet the following requirements:
Education and Experience (Minimum Qualifications)
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.
Special Requirements
A pre-employment criminal history check and fingerprinting are required. Persons offered employment in this position will be required to pay for fingerprinting.
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.
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.
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Direct Inquiries or Correspondence to:
Division of Human Resource Management Northern Nevada 515 East Musser Street, First Floor Carson City, Nevada 89701-4204
TDD for the Hearing Impaired (800) 326-6868
Division of Human Resource Management Southern Nevada 7251 Amigo St, Suite 120 Las Vegas, NV 89119
TDD for the Hearing Impaired (800) 326-6868
The State of Nevada is an equal opportunity employer dedicated to building diverse, inclusive, and innovative work environments with employees who reflect our communities and enthusiastically serve them. All applicants are considered without regard to race, color, national origin, religion or belief, age, disability, sex, sexual orientation, gender identity or expression, pregnancy, domestic partnership, genetic information (GINA), or compensation and/or wages.