Salary: $53,599 - $79,720 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 perform the full range of duties described above. 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. This is the journey level of the series. This position is located within the Department of Health and Human Services, Aging and Disability Services Division (ADSD) - Community Based Care in Reno, NV. ADSD provides an atmosphere of innovative thinking, teamwork, friendly co-workers, and provides a positive working environment. The mission of ADSD is to provide leadership and advocacy in the planning, development and delivery of a high quality, comprehensive support service system across the lifespan to allow all of Nevada's elders, children and adults with disabilities or special health care needs, to live independent, meaningful and dignified lives to the greatest extent possible. This position will act as a project lead; training newly hired staff; assist the intake team(s) in completing initial assessments; provide case management to recipients residing in independent home visits with recipients in their homes and in our group home settings which include completing social health assessments and level of care screenings; and conduct recipient contacts and reassessments as required. Additionally, this position will assist in providing nursing consultation and recommendations to Community Based Care staff, which includes reviewing medical records for eligibility purposes. This position may also assist with case file reviews, preparing necessary forms, reports, and inputting data. Nevada offers sunshine and recreational opportunities abound including golfing, biking, off-roading, hiking, skiing, and fishing. Nevada's beautiful landscape and thriving economy are just a few of the 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 each year; and accrual of 3 weeks of annual leave and 3 weeks of sick leave each year. Aging and Disability Services Division 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 identity and expression.
Announcement Number: 38227
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.