PASRR Nurse Consultant

State of North Carolina; Wake Forest (NC); Hybrid; USD 67,000 - 110,000; Full time

Benefits offered by this job

Health insurance

Retirement plans

NCFlex benefits

Paid vacation & sick leave

Parental leave

Job summary

The North Carolina Department of Health and Human Services (DHHS) Division of Health Benefits seeks a Nurse Consultant II to lead LTSS policy updates, audits, and PASRR program management for Medicaid beneficiaries.

The role requires an active NC RN license with two years of clinical experience, excellent communication skills, and proficiency in MS Office. It offers a hybrid work model and competitive benefits.

Qualifications

• Licensed to practice as a Registered Nurse in the State of North Carolina with two years of clinical experience.
• Strong oral and written communication skills.
• Proficiency in Microsoft Office (Outlook, Word, Excel).

Responsibilities

• Maintain an active role on the LTSS Team and advise on PASRR policy updates.
• Create and perform audits to prevent program abuse and ensure compliance.
• Review diagnoses, treatment costs, and vendor performance for quality control.

Skills

RN license NC

Clinical experience (2+ years)

Stakeholder relations

Oral & written communication

MS Office (Outlook, Word, Excel)

Education

RN license (NC)

Tools

Microsoft Office

Job description

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

Candidates 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.

Minimum Education and Experience

Some state job postings say you can qualify by an "equivalent combination of education and experience." If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See the Education and Experience Equivalency Guide for details.

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

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:

• 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.
• Paid parental leave is available to eligible employees.

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 federallaws, 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.

Degree/College Credit Verification

Degrees must be received from appropriately accredited institutions. Transcripts and degree evaluations may be uploaded with your application.

Veterans’ and National Guard Preference

• Applicants seeking Veteran’s Preference must attach aDD-214 Member-4 Form(Certificate of Release or Discharge from Active Duty) to their applications.
• Applicants seeking National Guard Preference must attach an NGB 23A (RPAS), along with the state application, if they are a current member of the NC National Guard in good standing.
• Applicants who are former members of either the NC Army National Guard or the NC Air National Guard, with honorable discharge and six years of creditable service, must attach a copy of the DD 256 or NGB 22, along with the state application.

ADA Accommodations

Consistent with the Americans with Disabilities Act (ADA) and the Pregnant Workers Fairness Act (PWFA), DHHS is committed to the full inclusion of all qualified individuals. As part of this commitment, DHHS will ensure that people with disabilities, or known limitations covered by the PWFA, are provided with reasonable accommodation. If reasonable accommodation is needed to participate in the job application or interview process, please contact the person Substance Abuse Professional Practice Board, etc.) indicated below.

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.