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, families, caregivers, and healthcare professionals.

• Execute assessments in beneficiaries’ residences and community environments utilizing standardized assessment tools.

• Engage with family members and informal caregivers during the assessment process.

• Complete assessments within specified timeframes.

• Perform expedited assessments via phone as necessary.

• Guide and assist members in choosing PCS providers.

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

• Submit service authorization requests (SARs) for PCS providers.

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

• Take part in mediation and appeals processes.

• Address state inquiries regarding completed assessments.

• Attend and contribute to staff meetings.

• Carry out case consultations, peer reviews, and internal audits as needed.

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

• Contribute to training for PCS stakeholders as required.

⛳️ Requirements

• A Bachelor’s degree in Nursing or another healthcare-related field is mandatory.

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

• Experience in conducting PCS assessments is highly preferred.

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

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

• Knowledge and comprehension of public sector services and supports.

• Proficiency in Microsoft Excel, Word, and Outlook.

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

• Strong communication skills through spoken, written, and electronic channels.

• Capability to work independently with minimal supervision.

• Proficiency in person-centered thinking and planning, with an awareness of the needs of individuals with disabilities.

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

• Willingness to travel as necessary to Rockingham, Forsyth, Surry, and Stokes counties.

🏝️ Benefits

• Competitive salary based on qualifications and experience.

• Exempt position not eligible for overtime compensation.

• Equal opportunity employer.