PCS Assessor, RN

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Conduct needs-assessments and determine eligibility for Medicaid beneficiaries seeking State Plan Personal Care Services.

• Arrange telephonic and in-person assessments within beneficiaries' homes and communities.

• Execute standardized PCS eligibility evaluations and interviews with family members and informal caregivers.

• Perform expedited assessments via phone when necessary.

• Offer education and guidance to members in selecting PCS providers.

• Collaborate with prescribers and healthcare professionals to ensure the accuracy and completeness of requests.

• Submit service authorization requests on behalf of PCS providers.

• Uphold the privacy and dignity of individuals receiving PCS assessments.

• Engage in mediation and appeal processes as required.

• Address state inquiries concerning completed assessments.

• Attend staff meetings and facilitate case consultations, peer reviews, and internal audits as assigned.

• Formulate level-of-care recommendations based on clinical evaluations.

• Participate in training sessions for PCS stakeholders as needed.

⛳️ Requirements

• Must reside in or around Buncombe, Henderson, Polk, Rutherford, or Madison County, North Carolina.

• Must live in North Carolina or within 40 miles of the North Carolina border.

• Willingness to travel as necessary to covered counties and other areas in western North Carolina, including Cherokee County.

• Bachelor’s degree in Nursing or a related healthcare field is required.

• Minimum of two years of experience in a home care environment.

• Active North Carolina Registered Nurse (RN) licensure is mandatory.

• Experience with community-based individuals requiring personal assistance with ADL and IADL tasks is highly preferred.

• Experience in conducting PCS assessments is highly preferred.

• Understanding of North Carolina Medicaid Clinical Coverage Policy 3L and the PCS Program Provider Manual.

• Familiarity with Medicaid-funded State Plan Personal Care Services, HCBS programs, and EPSDT.

• Knowledge of public sector services and supports.

• Proficient in Microsoft Excel, Word, and Outlook.

• Ability to operate computer equipment and navigate web-based software.

• Strong communication skills with office staff, healthcare professionals, patients, families, and other support systems.

• Capacity to prioritize tasks, pay attention to detail, and work independently.

• Ability to employ person-centered thinking and demonstrate awareness of the needs of individuals with disabilities.

• Capability to perform sedentary work, sit for extended durations, and lift up to 10 pounds.

🏝️ Benefits

• Equal opportunity employer.

• Exempt position; not eligible for overtime compensation.