Home Health Nurse Assessor; BHJOB_

Job Description

Home Health Registered Nurse – RN in North Carolina, providing care under the NC LIFTSS (Medicaid Linking Individuals & Families for Long-Term Services and Supports) project.

The role requires traveling within a region to conduct assessments and may involve occasional home office work. The position supports the Personal Care Services (PCS) program, delivering essential services for beneficiaries with medical conditions, cognitive impairments, or disabilities, ensuring they receive assistance for daily living activities (ADLs).

The position is part of the NC LIFTSS project, which streamlines access to LTSS programs.

Responsibilities include:

• Process referrals and perform option counseling
• Conduct assessments and quality assurance reviews
• Provide service plan management and customer service
• Conduct provider training for State Plan PCS, CAP/C, and CAP/DA programs

• Registered Nurse, licensed by the state of North Carolina
• Minimum two years experience in a home care setting
• Computer proficiency in Microsoft Excel, Word, Outlook, and web‑based software
• Experience with community‑based individuals needing personal assistance with ADL/IADL tasks (highly preferred)
• Experience conducting PCS assessments (highly preferred)
• Experience with OASIS or similar tool (highly preferred)
• Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual (highly desired)
• Knowledge of standards of practice related to Medicaid‑funded PC Services, HCBS programs, and EPSDT (highly desired)

• Conduct assessments to determine eligibility, using state‑approved assessment tools
• Ensure PCS are provided on a needs‑based basis with appropriate quantity in line with severity of condition
• Maintain privacy and dignity of beneficiaries during assessments
• Conduct timely new, expedited, annual, change‑of‑status, mediation/appeal, reconsideration, and derivative assessments
• Interview family members and informal caregivers present during assessment
• Provide guidance and assistance to beneficiaries for selecting PCS providers
• Conduct service plan reviews as needed
• Submit completed assessments via state‑approved interface
• Participate in beneficiaries’ mediation and appeal processes
• Respond to state inquiries regarding assessments
• Attend staff meetings and conduct case consultations/peer reviews/internal audits as assigned
• Develop level‑of‑care recommendations based on clinical evaluation
• Participate in training PCS stakeholders as needed
• Maintain computer proficiency with Excel, Word, Outlook, and web‑based software

• Insightful understanding of public sector services and supports
• Collaborative interaction with office staff, healthcare professionals, patients, families, and other supports
• Effective communication to individuals and groups in spoken, written, and electronic media
• Attention to detail and highly organized documentation to prioritize and execute tasks timely
• Person‑centered thinking, planning, and competency in awareness of needs of persons with disabilities

Mileage reimbursement for all travel.