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HEALTH CARE COORDINATOR 3 - NURSE

APPROXIMATE ANNUAL SALARY - $70,282.08 to $104,713.20 PAY GRADE: 37

The salary range indicated in this announcement is based on the Employee/Employer retirement compensation schedule. An employer-only option is available at a reduced salary range. Generally, salaries start at the lowest level of a step 1 and increase with each year of service to the highest level of a step 10.

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 in this geographical location.

Department: Health and Human Services (http://dhhs.nv.gov/)

Division: Health Care Financing & Policy

Job Class Code: 12.333

RECRUITMENT INFORMATION

Announcement Number: 51167

Open to all qualified persons.

Posted 04/15/2025

Recruiter:

ANA MARIA ORNELLAS

Phone: (775)684-0151

Email: [email protected]

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.

This opening is for a Health Care Coordinator 3 - Nurse within the Division of Health Care Financing and Policy Long Term Services and Supports (LTSS) unit and will be located in Reno. The Health Care Coordinator (HCC) Nurse position serves as the clinical expert for the LTSS unit. This includes evaluating medical records to determine medical necessity for a variety of LTSS Medicaid services, including appropriateness for out of state placements. The HCC Nurse also is the dedicated clinical reviewer for eligibility determinations for the Behaviorally Complex Care Program in Nursing Facilities and participates in the Fair Hearing process related to clinical decisions. In addition to medical necessity assessments, the HCC Nurse position serves as a consultant to policy and procedure updates for Home Health, Private Duty Nursing, Hospice, Nursing Facilities and Intermediate Care Facility for Individuals with Intellectual and Developmental Disabilities. ***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.

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

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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

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.

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