PCS Assessor RN
V
Vaya PartnersMedicaid personal care
Remote – must live in or near Rockingham County, Forsyth County, Surry County, Stokes County, North Carolina. The person in this role is required to maintain residency in North Carolina or within 40 miles of the NC border.Full-TimeJunior
Salary68,033.34 - 88,443.35 USD per year
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Job Details
- Experience
- Two years of experience in home care setting
- Required Skills
- Microsoft Excel
Requirements
- Bachelor’s degree in Nursing or another healthcare field.
- Two years of experience in a home care setting.
- Active licensure in North Carolina as a Registered Nurse (RN).
- Knowledge of North Carolina Medicaid Clinical Coverage Policy 3L and the PCS Program Provider Manual.
- Knowledge of practice standards for Medicaid-funded State Plan Personal Care Services, HCBS programs, and EPSDT.
- Computer proficiency in Microsoft Excel, Word, and Outlook.
- Ability to use computer equipment and web-based software.
- Ability to communicate effectively through spoken, written, and electronic media.
- Ability to prioritize tasks, attend to detail, and work independently.
- Experience with community-based individuals needing assistance with ADL and IADL tasks is highly preferred.
- Experience conducting PCS assessments is highly preferred.
Responsibilities
- Schedule assessments with members, family members, and healthcare professionals.
- Conduct standardized assessments to determine whether members meet PCS eligibility criteria.
- Interview family members and informal caregivers present during assessments.
- Complete assessments within established timeframes and conduct expedited assessments by phone when needed.
- Educate and assist members in selecting PCS providers.
- Work with prescribers and other healthcare professionals to ensure requests are accurate and complete.
- Submit service authorization requests on behalf of PCS providers.
- Participate in mediation and appeal processes as needed.
- Respond to state inquiries regarding completed assessments.
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