APPROXIMATE ANNUAL SALARY -
$51,865.92 to
$77,569.20
PAY GRADE: 38
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
Statewide.
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 supervise subordinate Health care Coordinators, other journey level professional and support personnel including hiring, evaluating performance, and administering disciplinary action. Incumbents plan and organize unit operations; develop procedures and guidelines; coordinate staff activities; evaluate the quality and quantity of work performed; prepare reports and recommendations to management; plan, arrange and/or proved training to staff members and providers; participate in community and public relations activities as assigned and assist with budgetary recommendations such as staffing, travel and program needs. Incumbents may be assigned to oversee a single program unit or a variety of programs, and they may be working supervisors who also perform the duties described above.
In order to be qualified, you must meet the following requirements:
Education and Experience (Minimum Qualifications)
Licensure as a Registered Nurse and three years of experience providing case management services in a social or health related field, one year of which included the interpretation and application of Medicaid policies and procedures, coordinating reviews and services, training staff and reviewing complex cases; OR licensure and an equivalent combination of education and experience.
Special Notes
A bachelor's degree in nursing is equivalent to a diploma or associate's degree in nursing and one year of experience.
Special Requirements
A State of Nevada/FBI background check will be required of the selected applicant.
A valid driver's license is required at the time of appointment and as a condition of continuing employment.
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
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.