Job title: Registered Nurse
Location: North Carolina Region
Position: Long term contract
Preferred Areas: Henderson, NC 27536, Youngsville, NC 27596, Oxford, NC 27565, Gastonia, NC 28054, Dallas, NC 28034, Bessemer City, NC 28016, Cramerton, NC 28032, Belmont, NC 28012, Kings Mountain, NC 28086, Mount Holly, NC 28120
Job Summary:
· The purpose of this position is to complete needs-based eligibility determinations for patients who are applying for Medicaid-funded personal care services provided in their home or in adult care or supervised living homes.
· This position also assesses level of care (LOC) to allow targeted individuals to remain in or return to a home and community-based setting.
· This role requires a valid driver's license and travel to various locations, which may include extended periods of driving (up to approximately 8 hours in a day).
· This role may require lifting up to 50 pounds
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. And 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.
· Registered Nurse NC.
· Minimum of two years' experience in a home care setting preferred.
