Job title: Clinical Assessor/ RN
Location: Elizabethtown, NC 28337 → Region 5
Position: Long term contract
Preferred Areas: St. Pauls, Parkton, Red Springs, Hope Mills, Tar Heel, Elizabethtown, Bladenboro
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.
- 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.
