DEPARTMENT OF HEALTH AND HUMAN SERVICES Division:
DHHS - HEALTH CARE FINANCING & POLICY Business Unit:
HR-HEALTH CARE FIN & POLICY Work Type:
PERMANENT Pay Grade:
GRADE 36 Salary Range:
$53,598.96 - $79,719.84 Fulltime/Parttime:
Full Time Recruiter:
TONYA M SIEBEN Phone:
775 684-2213 Email:
The Division of Health Care Financing and Policy is recruiting for a Health Care Coordinator 2 - RN located within the Care Coordination/Customer Service Unit in Las Vegas, Nevada. This position performs professional work related to program operations and auditing providers to ensure compliance with program policies and regulations; assesses potential client needs for case management services using assessment tools to identify social service and/or medical needs; participates in periodic reviews of facilities providing care to Medicaid eligible clients to validate and ensure adequacy of services and resident care; reviews health care providers and fiscal agents to ensure clients are receiving appropriate services and payment is correct for services received, processes 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; reviews 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; explains proper billing procedures to contract providers selected by the client; monitors the quality of care given by the provider to clients; and submits billings for services provided to the fiscal agent for payment.
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 three weeks of annual and sick leave each year.
Under direction, incumbents perform the full range of duties described in the series concept. 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. To view the full class specification visit: https://hr.nv.gov/uploadedFiles/hrnvgov/Content/Resources/ClassSpecs/12/12-332spc(9).pdf
THIS RECRUITMENT MAY CLOSE AT ANY TIME BASED ON THE NUMBER OF APPLICATIONS RECEIVED. QUALIFIED APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE.
The Examination Application Evaluation Exam
- 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.
- 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.
- A pre-employment criminal history check and fingerprinting are required. Persons offered employment in this position will be required to pay for fingerprinting.
- This position requires the incumbent to travel over a wide geographic area, either by motor vehicle or air travel, including commuter planes.
- 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.
- A valid driver's license is required at the time of appointment and as a condition of continuing employment.
- Travel at least 50% of the time is required.
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.
Nearest Major Market: Las Vegas