State of Nevada HEALTH CARE COORDINATOR 4 - NURSE in Nevada
HEALTH CARE COORDINATOR 4 - NURSE
APPROXIMATE ANNUAL SALARY -
PAY GRADE: 38
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.
Work Type: A Permanent, full time vacancy
Department: Health and Human Services
Division: Health Care Financing & Policy
Location: Las Vegas, Boulder City, Indian Springs, Jean, Henderson
Job Class Code:
Announcement Number: 32435
Open to current classified employees in state service with at least 6 months of continuous, full-time equivalent service.
for another 11 Days 2 Hrs 47 Mins
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 Health Care Coordinator 4-Nurse supervisor position is under the direction of the Department of Health and Human Services, Division of Health Care Financing and Policy (DHCFP), and is located in the Las Vegas District Office. This position is responsible for supervising subordinate Health Care Coordinators and Administrative Assistants, including the hiring, evaluating performance, and administering disciplinary action. The position plans and organizes unit operations; develops procedures and guidelines; coordinates staff activities; evaluates the quality and quantity of the work performed; prepares reports and recommendations to management; plans, arranges and trains staff members; participates in community and public relations; and assists with budgetary recommendations such as staffing, travel and program needs. This position supervises case management services to disabled children (recipients) eligible under the Katie Beckett Eligibility Option as determined by the Division of Welfare and Supportive Services. This position also supervises the Case Mix Review team and includes on site review of Minimum Data Set (MDS) documentation of long term care facilities to validate and ensure adequacy of services to Medicaid eligible recipients. The successful candidate will need to complete certification by the American Association of Nurse Assessment Coordinators (AANAC) as a Resident Assessment Coordinator (RAC-CT) after a period of training. The travel requirements for this position are less than 50%.
To see full Class Specifications visit:
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.
A bachelor's degree in nursing is equivalent to a diploma or associate's degree in nursing and one year of experience.
A pre-employment criminal history check and fingerprinting are required. Persons offered employment in this position will be required to pay for fingerprinting.
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
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.
The following additional questions are part of this Recruitment
1) Please describe your experience interpreting and applying Medicaid policies and procedures in the review and evaluation of medical facilities and services appropriate for payment. Include the number of years and where you performed these evaluations.
For more information about state employment, visit the following:
Division of Human Resource Management: http://hr.nv.gov
Public Employees Retirement System: http://www.nvpers.org
Public Employees Benefits Program: http://pebp.state.nv.us
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Direct Inquiries or Correspondence to:
Division of Human Resource Management Northern Nevada 209 East Musser Street, Room 101 Carson City, Nevada 89701-4204TDD for the Hearing Impaired (800) 326-6868
Division of Human Resource Management Southern Nevada 555 East Washington Avenue, Suite 1400 Las Vegas, Nevada 89101-1046TDD for the Hearing Impaired (800) 326-6868
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