HEALTH CARE COORDINATOR 3 - NURSE APPROXIMATE ANNUAL SALARY - $70,282.08 to $104,713.20 PAY GRADE: 37 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. JOB INFORMATION Work Type: Permanent, full time vacancies as they may occur Statewide. Department: Health and Human Services (http://dhhs.nv.gov/) Division: Aging & Disability Services Job Class Code: 12.333 RECRUITMENT INFORMATION Announcement Number: 49506 Open to all qualified persons. Posted 11/06/2024 Recruiter: ANA MARIA ORNELLAS Phone: (775)684-0151 Email: aornellas@admin.nv.gov 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. 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. Incumbents function at the advanced journey level and either; 1) Perform the full range of duties described above and function as a team leader for assigned programs as a permanent assignment. Incumbents coordinate reviews and services, assist in training, and review complex cases with lower level Health Care Coordinators. In addition to ongoing leadworker responsibility, incumbents may serve as the primary assistant to the supervisor; develop policies and procedures; assist in the maintenance of the State plan; develop forms and provide technical assistance with the assigned programs; or 2) Serve as the statewide technical expert and provide guidance on a statewide basis to the staff of an agency such as the Division of Aging Services. Incumbents provide clarification of a condition, medication, procedure or related circumstance in case management situation; anticipate training needs, and develop and present training modules for staff; develop, implement and monitor staff compliance with State laws regarding the agency's function in the community and communicable diseases; and assist staff in developing resources and preventive health care information for the clientele served. Aging and Disability Services Division (ADSD) is currently recruiting for a full-time Health Care Coordinator 3 Nurse statewide. This recruitment may be used to fill current and future vacancies as they occur in the following programs: Home and Community Based Services (HCBS), Policy Unit. The incumbent in this position will ensure program compliance with policies and regulations, working independently with minimal training. Responsibilities include assisting the supervisor, developing policies for Medicaid Waiver compliance, creating forms, and providing technical support. ADSD provides an atmosphere of innovative thinking, teamwork, friendly co-workers, a positive working environment and is committed to fostering an environment of both inclusiveness and diversity within our workforce. The mission of ADSD is to provide leadership and advocacy in the planning, development, and delivery of 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. 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/ To Qualify: In order to be qualified, you must meet the following requirements: Education and Experience (Minimum Qualifications) 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. Special Requirements A State of Nevada/FBI background check will be required of the selected applicant. 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. Travel up to 25%. The Examination 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. INFORMATIONAL LINKS 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: https://pebp.nv.gov/ More Benefits Information: http://nvjobs.nv.gov/Applicants/EB REFER A FRIEND Help us reach qualified candidates! Refer a friend by clicking here: Email Direct Inquiries or Correspondence to: Division of Human Resource Management Northern Nevada 515 East Musser Street, First Floor Carson City, Nevada 89701-4204TDD for the Hearing Impaired (800) 326-6868 Division of Human Resource Management Southern Nevada 7251 Amigo St, Suite 120 Las Vegas, NV 89119TDD for the Hearing Impaired (800) 326-6868 To begin the application process, click on the Apply button. Click Cancel to return to the previous page.