Health Care Coordinator 2 - Nurse

The Position

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. This position is for Health Care Coordinator, II, RN with case management experience to apply to the management of children cared for in the home on the Katie Beckett Eligibility Option.

This position oversees, and assists with case support and assistance navigating the Medicaid services of children with medically fragile or with intellectual disabilities being cared for in the home. Assessment of the level of care needed to safely maintain the home environment and assistance with the services available within the Medicaid provisions for Nevada. This position conducts home visits for assessment of the child in the home environment at a minimum annually.

Travel to these assessments is required. This position may also involve the audit process for skilled nursing facilities of the Minimum Data Set. Attainment of certification of this process is necessary within the first year.

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 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. * THIS RECRUITMENT MAY CLOSE WITHOUT FURTHER NOTICE DEPENDING ON THE NUMBER OF APPLICATIONS RECEIVED. APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE*

To see full Class Specifications visit: http://hr.nv.gov/Resources/ClassSpecs/Class_Specifications-12_0/