PASRR Nurse Consultant

Adult Correction; North Carolina; Hybrid; USD 67,000 - 110,000; Full time

Benefits offered by this job

Health insurance

Retirement plans

Parental leave

Paid leave

NCFlex benefits

Job summary

The North Carolina Department of Health and Human Services (DHHS) seeks a Nurse Consultant II (NS) to maintain an active LTSS Team role, recommend policy changes as programs develop, and plan and audit PASRR policies to safeguard Medicaid beneficiaries and control program costs.

Responsibilities include quality control through diagnoses reviews, invoice evaluations, and vendor performance audits, with a hybrid-telework schedule including weekly onsite work hours.

Qualifications

• Licensed to practice as a Registered Nurse in North Carolina with two years of clinical experience.
• Proven ability in establishing and maintaining effective working relationships with internal and external stakeholders.
• Excellent oral and written communication skills.
• Demonstrated ability to translate complex medical and regulatory requirements into practical policies and procedures.
• Proficiency in Microsoft Office, including Outlook, Word, and Excel.

Responsibilities

• Maintain an active role on the LTSS Team and recommend changes in policy as practice patterns change.
• Plan, implement and update PASRR policy; create and perform audits to prevent program abuse.
• Assess and document the PASRR program and ensure quality control through review of diagnoses, related treatment, and costs.
• Evaluate invoices and conduct monthly audits of vendor performance; assure compliance with Federal and State standards.
• Impact the safety and well-being of Medicaid beneficiaries seeking admission to Medicaid-certified nursing homes while ensuring proper use of public funds.

Job description

Position Title

Nurse Consultant II (NS)

Position Number

60042699

Grade

MH17

About Us

The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.

Description of Work

The position is responsible for maintaining an active role on the LTSS Team. The Nurse Consultant recommends changes in policy as practice patterns change and new programs and services are developed. It is responsible for the planning, implementation and updating of PASRR policy. The position is responsible for creating and performing audits to prevent program abuse, assessing and documenting the PASRR program.

The Nurse Consultant is also responsible for assuring that quality control is maintained through review of diagnoses, related treatment, costs incurred; evaluation of invoices, monthly audits of vendor performance, and assurance of compliance with Federal and State standards. The responsibilities of this position directly affect the safety and well-being of Medicaid beneficiaries seeking admission to Medicaid certified nursing homes as well as the effective expenditure of public funds relating to this program.

Position Eligibility

Position is eligible for a hybrid-teleworking schedule to include weekly onsite work hours

Qualifications

Salary Grade Range $66,696 - $110,049

Recruitment Range $66,696 - $ 81,612

Applicants now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement.

The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred:

• Licensed to practice as a Registered Nurse in the State of North Carolina and two years of clinical experience in the area of specialization.


• Proven ability in establishing and maintaining effective working relationships with internal and external stakeholders.


• Excellent oral and written communication skills.


• Demonstrated ability to understand and translate complex medical and regulatory requirements into practical, clear and unambiguous policies and procedures.


• Proficiency in Microsoft Office, including Outlook, Word, and Excel.

Management Preferences

• Familiarity with relevant and current NC Medicaid operations


• Knowledge of Long-Term Care, Managed Care and Home and Community Based Services


• Familiarity with NCMUST

Posting Details

Posting closes at 11:59 p.m. the night before the closing date

Position is funded in part through federal funds

About the NC Division of Health Benefits

The Division of Health Benefits (DHB) within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $27 billion in state and federal funds per fiscal year, DHB ensures that more than 108,000 enrolled providers are reimbursed for delivering covered services to 3.1 million beneficiaries.

Compensation & Benefits

The State of North Carolina offers excellent comprehensive benefits. Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis). Employees also receive paid vacation, sick, and community service leave. In addition, paid parental leave is available to eligible employees.

Visit website for State Benefits

Supplemental and Contact Information

The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer that embraces an Employment First philosophy, which consists of complying with all federal laws, state laws, and Executive Orders. We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job. For more information about DHHS: https://www.ncdhhs.gov/ .

DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position.

In accordance with the Governor's Executive Order 303 , our agency supports second-chance employment for individuals who were previously incar