Remote PCS Assessor RN — Home-Based Medicaid Expert

Vaya Health; Lexington (NC); Remote; USD 65,000 - 90,000; Full time

Job summary

Vaya Partners is seeking a Registered Nurse to perform needs-based assessments for Medicaid beneficiaries in North Carolina, conducting telephonic and face‑to‑face visits in home and community settings, and coordinating service authorization requests for PCS providers.

The PCS Assessor must hold an active NC RN license, a Bachelor's degree in Nursing or a related field, and at least two years of home care experience.

Qualifications

• Knowledge of NC Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual.
• Knowledge of HCBS and EPSDT standards in Medicaid.
• Public sector services understanding.
• Proficiency in MS Office (Excel/Word/Outlook).

Responsibilities

• Schedule assessments with members, families, and healthcare professionals.
• Conduct assessments to determine PCS eligibility using standardized tools.
• Interview family members and caregivers, ensuring timely assessments.
• Submit SARs on behalf of PCS providers and ensure accuracy.
• Maintain privacy and dignity of beneficiaries throughout assessments.
• Participate in mediation, appeals, and state inquiries as needed.

Skills

Knowledge of NC Medicaid Policy

Public sector services

Strong communication skills

Computer proficiency

Detail oriented

Independent work

Education

Bachelor's degree in Nursing or related field

Tools

Microsoft Excel

Microsoft Word

Outlook

Job description

Vaya Partners is seeking a Registered Nurse to perform needs-based assessments for Medicaid beneficiaries in North Carolina, conducting telephonic and face‑to‑face visits in home and community settings, and coordinating service authorization requests for PCS providers.

The PCS Assessor must hold an active NC RN license, a Bachelor's degree in Nursing or a related field, and at least two years of home care experience.