Rn Jobs

About The Position

Requirements

• Registered Nurse (NC or Compact license)
• Minimum of two years of nursing experience.
• This position requires travel up to a 60 mile radius.
• Computer proficiency in Microsoft Excel, Word and Outlook.
• Ability to utilize computer equipment and web-based software to conduct work.
• Ability to interact with various office staff as needed to support necessary workflows.
• Ability to interact with healthcare professionals, patients, their families and other supports.
• Ability to communicate effectively to individuals and groups through spoken, written and electronic media.
• Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.
• Ability to work independently without a high degree of supervision.
• Develops level of care recommendations based upon clinical evaluations.

Nice To Haves

• Experience with community-based individuals needing personal assistance with ADL and IADL tasks is highly preferred.
• Experience conducting PCS assessments highly preferred.
• 2+ years of home healthcare experience preferred.
• 2+ years of directly-related experience (preferably case management) in the health or medical field, directly related to homecare, long-term care, or personal care is preferred.
• Experience conducting HCBS waiver assessments highly preferred.
• Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
• Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
• Knowledge and understanding of public sector services and supports.
• Participates in training of PCS stakeholders as needed.
• Ability to use person-centered thinking, planning, and have competency in awareness of the needs of persons with disabilities.
• Knowledge of North Carolina Medicaid Clinical Policy 3K-1 and 3K-2, and 42 CFR Part 441 Subpart G, 42 CFR § 440.180.
• Knowledge of eligibility criteria for LOC and Waiver Participation.
• Knowledge of standards of practice related to Medicaid waivers, home and community-based services (HCBS) programs, EPSDT, medical fragility, and level of care determinations.
• Participates in training of CAP stakeholders as needed.

Responsibilities

• Conduct assessments to determine whether the beneficiary meets the conditions and criteria for PCS eligibility, using state-approved standardized assessment tool(s).
• Ensure PCS are provided on a "needs basis" in quantities appropriate to the Beneficiary's unmet need for services based on the severity of their medical condition, functional disability, physical, or cognitive impairment.
• Ensure the privacy and dignity of individuals receiving assessment for PCS is maintained at the highest standards.
• Ensure that new, expedited, annual, change of status, mediation/appeals, reconsideration review, and derivative assessments are conducted within established timeframes.
• Include an interview with family members and informal caregivers who are present at the time of the assessment.
• Provide the Beneficiary with guidance and assistance, as necessary, to select PCS providers.
• Conduct service plan reviews as needed.
• Submit the completed assessments using state-approved interface.
• Participate in the Beneficiary's mediation and appeal processes.
• Respond to state inquiries regarding assessments conducted.
• Attend and actively participate in staff meetings and conduct case consultations/peer reviews/internal auditing as assigned.
• Provide assessments for initial eligibility determinations for an applicant to participate in a 1915(c) HCBS program, and, when applicable, annual and change of status assessments for participants currently participating in a 1915(c) HCBS program, using state-approved standardized assessment tool(s).
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Benefits

• comprehensive health plans
• paid time off
• retirement savings
• corporate wellness
• educational assistance
• corporate discounts