APPROXIMATE ANNUAL SALARY -
$60,635.52 to
$90,180.72
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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Work Type: Permanent, full time vacancies as they may occur
in this geographical location.
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Department: Health and Human Services |
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Division: Health Care Financing & Policy |
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Location: Las Vegas, Boulder City, Indian Springs, Jean, Henderson |
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Job Class Code:
12.334
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Announcement Number: 45191
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Open to all qualified persons. |
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Posted
11/17/2023
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Recruiter:
ANA MARIA
ORNELLAS
Phone: (775)684-0151
Email: aornellas@admin.nv.gov
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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.
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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.
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 NV. 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. Health Care Coordinators in this position use multiple databases to research recipient data, eligibility information, and computer system interface issues. This position accepts Care Coordination cases and Serious Occurrence Follow-up cases. To include assisting Medicaid recipients in accessing their healthcare and assessing their needs to prevent further serious occurrences.
This position performs outreach to the general public, providers, community agencies, groups and organizations regarding Medicaid functions, policies, and services in the rural and urban communities covered by the Las Vegas District Office. They may attend meetings in the community and speak to groups and individuals; attend health fairs and respond to inquiries and concerns from clients and the general public. This position will assist walk-ins in the District Office lobbies to provide the recipient information regarding benefits and to troubleshoot complicated access to care issues. Position requires professional licensure or certification as a Registered Nurse issued by the State of Nevada Board of Nursing at the time of appointment. Incumbents must maintain professional licensure or certification in their specialty as a condition of continuing employment. This position will assist walk-ins in the District Office lobbies to provide the recipient information regarding benefits and to troubleshoot complicated access to care issues.
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; 12 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.
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 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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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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