Homecare RN Assessor

Vaya Health; North Carolina; Remote; USD 65,000 - 95,000; Full time

Job summary

Vaya Health is seeking a Remote PCS Assessor Registered Nurse to perform needs-based assessments for Medicaid beneficiaries in western North Carolina. You will travel to Buncombe, Henderson, Polk, Rutherford and Madison counties, conducting telephonic and in-home assessments with nurses, providers, and families.

Licensure in NC RN is required, with two years in home care preferred. The role emphasizes coordination with prescribers, submitting SARs, and applying NC Medicaid policies while

Qualifications

• Bachelor's degree in Nursing and RN licensure in North Carolina.
• Minimum two years in a home care setting with ADL/IADL experience preferred.
• Ability to travel/distance to multiple counties as required.

Responsibilities

• Schedule telephonic and in-home assessments for Medicaid beneficiaries.
• Perform needs-based assessments and eligibility determinations.
• Submit SARs on behalf of PCS providers.
• Educate members to help select PCS providers.
• Collaborate with prescribers and healthcare professionals.
• Maintain knowledge of NC Medicaid policy and PCS manuals.

Skills

Assessment scheduling

Travel to counties

Clinical evaluation

Communication with providers

Education

Bachelor's degree in Nursing

Active NC RN licensure

Tools

Microsoft Excel

Microsoft Word

Outlook

Web-based software

Job description

Remote – must live in or near Buncombe County, Henderson County, Polk County, Rutherford County, or Madison County, North Carolina. This position will serve Buncombe County, NC, Henderson County, NC, Polk County, NC, Rutherford County, NC, Madison County, NC and will occasionally travel to serve other western North Carolina counties through Cherokee County. 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.

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.

• 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.