Salary: $49,152 - $72,871 per yr
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 become familiar with Medicaid policies and procedures and receive training in the duties described above. This is the entry level in the series and progression to the journey level may occur upon successful completion of the probationary period, meeting the minimum qualifications, and with the recommendations of the appointing authority. This vacancy is within the Division of Health Care Financing and Policy - District Office, located in Reno, NV. The incumbent will be underfilling a Health Care Coordinator 2 - Nurse, and will auto-progress to the next level in the series upon meeting the minimum qualifications and upon appointing authority approval. This position assesses and provides care coordination services to disabled children eligible under the Katie Beckett Eligibility Option as determined by the Division of Welfare and Supportive Services. This position would also conduct provider reviews and or site visits to evaluate for compliance of state and federal regulations or for provider enrollment requirements and report findings within short time constraints to contribute to the health, safety, and welfare of Medicaid 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 up to 50%. 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; 11 paid holidays; and accrual of 3 weeks of annual and 3 weeks of sick leave each year. DHCFP 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, pregnancy, genetic information (GINA), or gender.
Announcement Number: 37455
Open to all qualified persons.
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.