Department: 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 37
Salary Range: $55,958.40 - $83,394.72
Fulltime/Parttime: Full Time
Recruiter: LISA D FRIEND
Phone: 775 684-0110
This opening is for a Health Care Coordinator 3 - RN within the Division of Health Care Financing and Policy's (DHCFP's), Program Integrity Surveillance Utilization Review (SUR) unit, in Las Vegas.
Under the general direction of the SUR Manager, this position performs a detailed review and analysis of Medicaid claims data and billing practices to identify and evaluate cases of suspected fraud, waste, abuse, and improper payments. This position serves as the Provider Type Coordinator/subject matter expert for all provider types as assigned and demonstrates a clear understanding of all applicable policies, rules, and procedures for those provider types. Other responsibilities include being a medical consultant to all coworkers. A valid State of Nevada nursing license is required.
To view full class specification visit: https://hr.nv.gov/uploadedFiles/hrnvgov/Content/Resources/ClassSpecs/12/12-332spc(9).pdf
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 3 weeks of annual and sick leave each year.
Licensure as a Registered Nurse and two years of professional experience providing case management services in a social or health related field; OR one year of experience as a Health Care Coordinator II - Nurse in Nevada State service; OR licensure and an equivalent combination of education and experience as described above.
Application Evaluation Exam
The exam will consist of an application and resume evaluation. It is essential that applications/resumes 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.
- 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.
- A valid driver's license is required at the time of appointment and as a condition of continuing employment.
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 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: