PCS Assessor, RN

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

📋 Description

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

• Arrange telephonic and in-person assessments with members, their families, caregivers, and healthcare professionals.

• Execute standardized PCS eligibility assessments within beneficiaries’ residences and communities.

• Interview family members and informal caregivers as part of the assessment process.

• Complete assessments within designated timeframes.

• Perform expedited assessments via telephone when necessary.

• Educate and guide members in choosing appropriate PCS providers.

• Collaborate with prescribers and healthcare professionals to ensure that requests are both accurate and comprehensive.

• Submit service authorization requests on behalf of PCS providers.

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

• Engage in mediation and appeal processes as required.

• Address state inquiries related to completed assessments.

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

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

• Take part in training sessions for PCS stakeholders as necessary.

⛳️ Requirements

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

• A minimum of two years of experience in a home care environment.

• Active licensure as a Registered Nurse (RN) in North Carolina is required.

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

• Prior experience conducting PCS assessments is highly preferred.

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

• Understanding of the standards of practice related to Medicaid-funded State Plan Personal Care Services, HCBS programs, and EPSDT.

• Knowledge of public sector services and supports.

• Proficiency in Microsoft Excel, Word, and Outlook.

• Capability to utilize computer equipment and web-based software effectively.

• Strong communication skills in spoken, written, and electronic formats.

• Ability to work independently with minimal supervision.

• Competency in person-centered thinking and planning, with a keen awareness of the needs of individuals with disabilities.

• Must reside in North Carolina or within 40 miles of the state's border.

• Willingness to travel as necessary to Alamance, Chatham, and Caswell counties.

🏝️ Benefits

• This is an exempt position, not eligible for overtime compensation.

• We are an equal opportunity employer.