Remote RN PCS Assessor for In-Home Care Eligibility

Vaya Health; Winston-Salem (NC); Remote; USD 70,000 - 95,000; Full time

Job summary

Vaya Health is seeking a Registered Nurse for the Personal Care Services (PCS) Assessor role. You will conduct needs-based assessments for Medicaid beneficiaries in their homes, scheduling visits and delivering telephonic and face-to-face assessments across NC counties.

You will collaborate with clinicians, educate families, and submit SARs for PCS providers while safeguarding patient privacy and dignity. Residency in North Carolina or within 40 miles of the NC border is required, with some

Qualifications

• Bachelor’s degree in Nursing or other healthcare field required.
• Two years of experience in home care setting preferred.
• Experience conducting PCS assessments preferred.

Responsibilities

• Schedule assessments with members, family members, and/or other healthcare professionals.
• Determine PCS eligibility using standardized assessment tools.
• Interview family members and caregivers present at assessments.
• Ensure assessments are completed within established timeframes.
• Conduct expedited assessments over the phone as needed.
• Educate and assist members to select PCS providers.
• Collaborate with prescribers and other healthcare professionals to ensure requests are accurate and complete.
• Submit service authorization requests (SARs) for PCS providers.
• Maintain privacy and dignity of individuals receiving PCS assessments.
• Participate in mediation and appeal processes as needed.
• Respond to state inquiries regarding assessments.

Skills

NC Medicaid knowledge

Public sector services

Microsoft Office

Communication skills

Independent work

Detail-oriented

Case coordination

Education

Bachelor’s degree in Nursing

2+ years home care experience

Tools

Microsoft Excel

Microsoft Word

Outlook

Job description

Vaya Health is seeking a Registered Nurse for the Personal Care Services (PCS) Assessor role. You will conduct needs-based assessments for Medicaid beneficiaries in their homes, scheduling visits and delivering telephonic and face-to-face assessments across NC counties.

You will collaborate with clinicians, educate families, and submit SARs for PCS providers while safeguarding patient privacy and dignity. Residency in North Carolina or within 40 miles of the NC border is required, with some