PCS Assessor, Registered Nurse
Posted 11hrs ago
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Job Description
Registered Nurse assessing Medicaid-beneficiaries for Personal Care Services eligibility. Responsibilities include scheduling assessments and submitting service authorization requests on behalf of PCS providers.
Responsibilities:
- Responsible for completing needs-based assessments/eligibility determinations for Medicaid-beneficiaries
- Conduct assessments to determine whether members meet the conditions and criteria for PCS eligibility
- Schedule assessments and conduct interviews with family members and informal caregivers
- Submit service authorization requests (SARs) on behalf of PCS providers
- Ensure privacy and dignity of individuals receiving assessment is maintained at the highest standards
- Participate in mediation and appeal processes as needed
Requirements:
- Bachelor’s degree in Nursing or other healthcare field required
- Two years of experience in home care setting
- Experience with community-based individuals needing personal assistance with ADL and IADL tasks is highly preferred
- Experience conducting PCS assessments highly preferred
- Must have active licensure in North Carolina as a Registered Nurse (RN).
- Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
- Knowledge and understanding of public sector services and supports
- Computer proficiency in Microsoft Excel, Word and Outlook
- Ability to utilize computer equipment and web-based software to conduct work
- Ability to communicate effectively to individuals and groups through spoken, written and electronic media.
Benefits:
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development opportunities
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