PCS Assessor, RN

Vaya Health

. Complete needs-based assessments and eligibility determinations for Medicaid beneficiaries applying for State Plan Personal Care Services .

Posted 10/10/2026full-timeRemote • North Carolina • United StatesJuniorMid-Level💰 $68,033 - $88,443 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in conducting Medicaid assessments and eligibility determinations while maintaining compliance with North Carolina Medicaid policies. Proficient in collaborating with healthcare professionals and providing education to beneficiaries regarding personal care services.

Highest-signal resume keywords

North Carolina Registered Nurse (RN) LicensureMedicaid AssessmentsPersonal Care Services (PCS) AssessmentsCommunity-Based Care ExperienceKnowledge of North Carolina Medicaid Policies

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Needs-Based AssessmentsEligibility DeterminationsLevel-of-Care RecommendationsClinical EvaluationsService Authorization RequestsMediation and Appeal ProcessesADL and IADL Task AssistancePerson-Centered Thinking

Soft Skills

Effective CommunicationDetail OrientationIndependent WorkCollaboration

Tools & Technologies

Microsoft ExcelMicrosoft WordMicrosoft OutlookWeb-Based Software

Certifications & Qualifications

Bachelor’s Degree in NursingActive North Carolina Registered Nurse (RN) Licensure

Industry Keywords

MedicaidHome Care SettingHCBS ProgramsEPSDTPublic Sector Services

About the role

Key responsibilities & impact

Complete needs-based assessments and eligibility determinations for Medicaid beneficiaries applying for State Plan Personal Care Services
Schedule telephonic and face-to-face assessments in beneficiaries’ homes and communities
Conduct standardized PCS eligibility assessments and interviews with family members and informal caregivers
Complete expedited assessments by phone when needed
Provide education and assistance to members selecting PCS providers
Collaborate with prescribers and healthcare professionals to ensure requests are accurate and complete
Submit service authorization requests on behalf of PCS providers
Maintain the privacy and dignity of individuals receiving PCS assessments
Participate in mediation and appeal processes
Respond to state inquiries regarding completed assessments
Attend staff meetings and conduct case consultations, peer reviews, and internal audits as assigned
Develop level-of-care recommendations based on clinical evaluations
Participate in training PCS stakeholders as needed

Requirements

What you’ll need

Must live in or near Buncombe, Henderson, Polk, Rutherford, or Madison County, North Carolina
Must reside in North Carolina or within 40 miles of the North Carolina border
Ability to travel as needed to covered counties and other western North Carolina counties through Cherokee County
Bachelor’s degree in Nursing or another healthcare field required
Two years of experience in a home care setting
Active North Carolina Registered Nurse (RN) licensure required
Experience with community-based individuals needing personal assistance with ADL and IADL tasks highly preferred
Experience conducting PCS assessments highly preferred
Knowledge of North Carolina Medicaid Clinical Coverage Policy 3L and PCS Program Provider Manual
Knowledge of Medicaid-funded State Plan Personal Care Services, HCBS programs, and EPSDT
Knowledge of public sector services and supports
Proficiency in Microsoft Excel, Word, and Outlook
Ability to use computer equipment and web-based software
Ability to communicate effectively with office staff, healthcare professionals, patients, families, and other supports
Ability to prioritize tasks, attend to detail, and work independently
Ability to use person-centered thinking and demonstrate awareness of the needs of persons with disabilities
Ability to perform sedentary work, sit for extended periods, and lift up to 10 pounds

Benefits

Comp & perks

Equal opportunity employer
Exempt position; not eligible for overtime compensation