- - Consultant (Jobs in Nashville, NC)   Requirement id 140255 Job title Consultant Job location in Nashville, NC Skills required Bachelors Degree, -, -, Open Date 14-Apr-2023 Close Date Job type Contract Duration 15 Months Compensation DOE Status requirement --- Job interview type --- Apply    Email Recruiter: coolsoft Job Description Consultant: Bachelors Degree, -, -, Start date :04/03/2023 End Date :06/30/2024 Submission deadline : 04/24/2023 Client Info : TN TennCare Note: * Position Location On Site Description : The LTSS Operations team is requesting a contractor to assist with nurse related functions for LTSS programs. This includes making eligibility determinations for applicants in a way that aligns with TennCare Rule and level of care (LOC) requirements for Nursing Facility LOC and At Risk LOC. Assist with data entry into newly implemented eligibility system. The new eligibility system implementation of PERLSS has increased the workload of existing team members and additional support is needed to maintain daily functions of the PHNC team to ensure LOC determinations are handled timely and accurately. The contractor role will allow the PHNC team members to manage PERLSS related work, including monitoring and reporting defects, process improvements, and required work related to additional PERLSS implementation phases. Description of Duties (PROJECT-BASED) % of Total Work Effort PAE Adjudication functions: Review submitted PAEs, Medicaid medical eligibility applications, for level of care determinations for approval or denial for LTSS programs utilizing clinical expertise. Decisions must be made in accordance with TennCare Rule. Ensure compliance with Federal PASRR regulations with adjudicating PAEs for CHOICES program, specific to those seeking to resident and receives services in a nursing facility. This also includes adjudicating skilled service requests, Enhanced Respiratory Care request, safety requests, and target population decisions. 70% Transcribe approved PASRR determinations from the TMED system into the PERLSS system to allow for additional enrollment and eligibility actions to be taken on completed records. 30% Action Plan Timeline The contractor will be needed for 12 months. Months 1-2: Training on new role, including shadowing and completion of new hire onboarding process. Month 3: The contractor will begin working independently, with hands on support and monitoring of supervisor, on PHNC 2 related tasks. These include determining LOC for applicants and entering data into the eligibility system. Weekly check ins to occur with supervisor to monitor productivity and answer questions. Months 4-10: The contractor will be fully independent in role and providing support with appeal tasks. This will also include providing required reports, as needed, to supervisor. In months 9 and 10, the supervisor and contractor will begin discussing transition plan for tasks, to include a review of eligibility system implementation related tasks that are close to completion or have already been completed. Months 11-12: The contractor will work with the PHNC team on transitioning responsibilities to team members and finalizing outstanding work tasks. The contractor and supervisor will create a transition plan to minimize transition related gaps, ensuring compliance to Rules and required timeframes for LOC determinations. Minimum qualifications Graduation from an accredited college or university with a bachelors degree in nursing and experience equivalent to four years of full-time increasingly responsible professional nursing work Excellent verbal and written communications skills Proven technical skills (e.g. Microsoft Word, Excel, Outlook, PowerPoint, SharePoint, etc.) Excellent time management skills and ability to multi-task and prioritize work in order to meet specific timeframes anddeadlines with minimal supervision Keen attention to detail and adherence to deadlines Organization Self-motivated and able to thrive in a fast-paced and results-driven environment Critical thinking and problem-solving skills   Call 502-379-4456 Ext 100 for more details. Please provide Requirement id: 140255 while calling.   Other jobs in NC: Chapel Hill (2), Charlotte (58), Dix Campus (1), Greensboro (3), Morrisville (2), North Charlotte (2), Raleigh (96), St Raleigh (2), Winston Salem (3),    Bachelors Degree job openings in other states Jobs List SYSTEMS SOFTWARE PROGRAMMER - CONSULTANT-11658-1 Create date: 06-May-2025 Start date : 6/6/2025 Submission deadline : 5/13/2025 Client Info : Department of Health and Human Services Note: Q) INTERVIEW PROCESS (phone, video or in-person, how many rounds of i/vs, etc)? A) In person or video may be used for interview(s). Description : The Replaceme.... 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