Homecare RN Assessor

Vaya Health; Clayton (NC); Remote; USD 60,000 - 80,000; Full time

Job summary

Vaya Health in North Carolina seeks a Personal Care Services (PCS) Assessor RN to complete needs-based assessments for Medicaid beneficiaries in their home or community settings. The role entails scheduling, telephonic and in-person assessments, and submitting SARs for PCS providers.

Candidates must hold a NC RN license and have at least two years of home care experience, with strong computer skills and the ability to work independently in a remote capacity.

Qualifications

• Bachelor’s degree in Nursing or healthcare field.
• Two years’ home care experience.
• Active North Carolina RN licensure.

Responsibilities

• Schedule appointments and conduct telephonic and in-home assessments.
• Submit service authorization requests for PCS providers.
• Educate members to select PCS providers.
• Coordinate with prescribers and healthcare professionals.
• Develop level of care recommendations based on clinical evaluations.
• Participate in PCS stakeholder trainings.

Skills

Assessment scheduling

Medicaid knowledge

RN licensure

Home care experience

Telephonic assessments

Travel readiness

Independent work

Person-centered planning

Nursing skills

MS Office tools

Education

Bachelor’s degree in Nursing or healthcare field

Tools

Microsoft Excel

Microsoft Word

Outlook

Job description

Remote – must live in or near Rowan County, Forsyth County, Iredell County, Yadkin County, Davie County, Davidson County North Carolina. This position will serve Rowan County, NC, Forsyth County, NC, Iredell County, NC, Yadkin County, NC, Davie County, NC, and Davidson County, NC. Must have ability to travel as needed to those counties.

The Personal Care Services (PCS) Assessor Registered Nurse is responsible for completing needs-based assessments/eligibility determinations for Medicaid-beneficiaries in Vaya Partners regions who are applying for State Plan Personal Care Services provided in their home or in adult care or supervised living homes. These Medicaid-beneficiaries have a medical condition, cognitive impairment, or disability and demonstrate unmet needs for hands-on assistance with qualifying activities of daily living (ADLs).

The PCS Assessor Registered Nurse is responsible for scheduling appointments, administering telephonic and face-to-face assessments in beneficiaries home and community, working with healthcare professionals, and submitting service authorization requests (SARs) on behalf of PCS providers.

Works with members, family members, and/or other healthcare professionals to schedule assessments.

• Performs expedited assessments over the phone as needed.
• Provides education and assistance to the member, as necessary, to select PCS providers.
• Works with prescribers and/or other healthcare professionals to ensure that requests are accurate and complete.
• Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
• Knowledge of standards of practice related to Medicaid-funded State Plan Personal Care Services, home and community-based services (HCBS) programs, and Early and Periodic Screening, Diagnostic and Treatment (EPSDT).
• Computer proficiency in Microsoft Excel, Word and Outlook.
• Ability to utilize computer equipment and web-based software to conduct work.
• Ability to interact with various office staff as needed to support necessary workflows.
• Ability to interact with healthcare professionals, patients, their families and other supports.
• Ability to work independently without a high degree of supervision.
• Develops level of care recommendations based upon clinical evaluations.
• Participates in training of PCS stakeholders as needed.
• Ability to use person-centered thinking, planning, and have competency in awareness of the needs of persons with disabilities.

Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.

Bachelor’s degree in Nursing or other healthcare field required and two years of experience in home care setting. Experience with community-based individuals needing personal assistance with ADL and IADL tasks is highly preferred. Must have active licensure in North Carolina as a Registered Nurse (RN).

This position is exempt and is not eligible for overtime compensation.