PCS Assessor, RN

Job Description:

• Complete needs-based assessments and eligibility determinations for Medicaid beneficiaries applying for State Plan Personal Care Services
• Schedule telephonic and face-to-face assessments with members, families, caregivers, and healthcare professionals
• Conduct standardized PCS eligibility assessments in beneficiaries’ homes and communities
• Conduct interviews with family members and informal caregivers
• Complete assessments within established timeframes
• Perform expedited assessments by telephone as needed
• Educate and assist members in selecting PCS providers
• Collaborate with prescribers and healthcare professionals to ensure requests are accurate and complete
• Submit service authorization requests on behalf of PCS providers
• Maintain the privacy and dignity of individuals receiving PCS assessments
• Participate in mediation and appeal processes
• Respond to state inquiries regarding completed assessments
• Attend staff meetings and conduct case consultations, peer reviews, and internal auditing as assigned
• Develop level-of-care recommendations based on clinical evaluations
• Participate in training PCS stakeholders as needed

Requirements:

• Bachelor’s degree in Nursing or other healthcare field required
• Two years of experience in a home care setting
• Active licensure in North Carolina as a Registered Nurse (RN) required
• Experience with community-based individuals needing personal assistance with ADL and IADL tasks highly preferred
• Experience conducting PCS assessments highly preferred
• Knowledge of North Carolina Medicaid Clinical Coverage Policy 3L and PCS Program Provider Manual
• Knowledge of standards of practice related to Medicaid-funded State Plan Personal Care Services, HCBS programs, and EPSDT
• Knowledge and understanding of public sector services and supports
• 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 work independently without a high degree of supervision
• Ability to use person-centered thinking and planning, with competency in awareness of the needs of persons with disabilities
• Must reside in North Carolina or within 40 miles of the North Carolina border
• Ability to travel as needed to Alamance, Chatham, and Caswell counties

Benefits:

• Exempt position; not eligible for overtime compensation
• Equal opportunity employer