PASRR Nurse Consultant

Health & Human Services; North Carolina; Hybrid; USD 67,000 - 110,000; Full time

Benefits offered by this job

Health insurance

Retirement plans

Paid vacation & sick leave

Job summary

The Nurse Consultant II (NS) position with the North Carolina Department of Health and Human Services is focused on PASRR policy, audits, and quality assurance to support Medicaid beneficiaries entering nursing homes. The role requires strong regulatory knowledge and collaboration with internal and external stakeholders.

Hybrid-teleworking with weekly onsite hours is available, and the posting outlines salary ranges and benefits under State compensation and health plans.

Qualifications

• Licensed to practice as a Registered Nurse in North Carolina.
• Two years of clinical experience in the area of specialization.
• Excellent oral and written communication skills.
• Ability to understand and translate complex medical and regulatory requirements into practical policies.

Responsibilities

• Maintain an active role on the LTSS Team and recommend policy changes as programs develop.
• Plan, implement and update PASRR policy; conduct audits to prevent program abuse.
• Evaluate invoices and vendor performance; ensure compliance with Federal and State standards.

Skills

RN licensure (NC)

Clinical experience

Oral and written communication

Policy interpretation

MS Office proficiency

Tools

Microsoft Office (Outlook, Word, Excel)

Job description

Agency Department

Agency Dept of Health and Human Services Division HEALTH BENEFITS Job Classification 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.

Knowledge Skills and Abilities / Management Preferences

Salary Grade Range: $66,696 - $110,049
Recruitment Range: $66,696 - $81,612

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

• 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 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

Equal Opportunity Statement

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 incarcerated or justice-involved. We invite all potential applicants to apply for positions for which they may be qualified.

Contact Information

If there are any questions about this posting, please contact Talent Acquisition at [e-mail].

Minimum Education and Experience

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

EEO Statement

The State of North Carolina is an Equal Employment Opportunity Employer and dedicated to providing employees with a work environment free from all forms of unlawful employment discrimination, harassment, or retaliation. The state provides reasonable accommodation to employees and applicants with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for religious beliefs, observances, and practices.