Remote RN: Personal Care Services Assessor (Medicaid)

Vaya Health; North Carolina; Hybrid; USD 68,000 - 88,000; Full time

Job summary

Vaya Health is seeking a PCS Assessor Registered Nurse to perform needs-based assessments for Medicaid beneficiaries in home or community settings across multiple western North Carolina counties. The role requires NC RN licensure and residency within NC or within 40 miles of the NC border.

The assessor will schedule and perform in-home and telephonic assessments, collaborate with healthcare professionals, and submit SARs for PCS providers while maintaining privacy and dignity of clients.

Qualifications

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

Responsibilities

• Schedule assessments with members, family members, and/or other healthcare professionals.
• Conduct needs-based assessments to determine PCS eligibility using standardized tools.
• Interview family members and informal caregivers present at the assessment.
• Ensure assessments are completed within established timeframes.
• Perform expedited assessments over the phone as needed.
• Educate and assist members to select PCS providers.
• Submit service authorization requests (SARs) on behalf of 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 conducted.

Job description

Vaya Health is seeking a PCS Assessor Registered Nurse to perform needs-based assessments for Medicaid beneficiaries in home or community settings across multiple western North Carolina counties. The role requires NC RN licensure and residency within NC or within 40 miles of the NC border.

The assessor will schedule and perform in-home and telephonic assessments, collaborate with healthcare professionals, and submit SARs for PCS providers while maintaining privacy and dignity of clients.