Clinical Assessor RN (Remote + Required Travel)

Clinical Assessor

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra Health is looking for a Clinical Assessor to join our growing team.

Job Summary:

Acentra Health is seeking clinical assessors statewide in North Carolina for an exciting opportunity. You work out of your home office and travel to assessment locations in your region. Under the Personal Care Services (PCS) program, services are provided to NC Medicaid Beneficiaries who have a medical condition, cognitive impairment, or disability who demonstrate unmet needs for hands-on assistance with qualifying activities of daily living (ADLs). The PCS Assessor is responsible for the completion of needs-based eligibility determinations for North Carolinians who are applying for these Medicaid-funded personal care services provided in their home or in adult care or supervised living homes.

Under the Community Alternatives (CAP) Program, home and community-based waivers provide cost-neutral alternatives to institutionalization for Beneficiaries, in specified target populations, who would be at risk for institutionalization if specialized Waiver services are not available. Services are intended for situations where no household member, relative, caregiver, landlord, community agency, volunteer agency, or third-party payer is able or willing to meet the assessed and required medical, psychosocial, and functional needs of the approved CAP Beneficiary.

The CAP/PCS Assessor is responsible for completion of needs-based assessments of level of care (LOC) to allow targeted individuals to remain in or return to a home and community-based setting. Assessments are generally performed in the beneficiary's primary residence.

Position is hybrid. Candidates should be based within Cabarrus County of North Carolina (Concord & surrounding cities) to be able to cover the field work involved.

Responsibilities:

• Conducts assessment to determine whether the beneficiary meets the conditions and criteria for PCS eligibility, using state-approved standardized assessment tool(s).
• Ensures that 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.
• Ensures that the privacy and dignity of individuals receiving assessment for PCS is maintained at the highest standards.
• Ensures 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 participant currently participating in a 1915(c) HCBS program, using state-approved standardized assessment tool(s).
• Ensures that CAP services 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.
• Ensures that the privacy and dignity of individuals receiving assessment for CAP participation is maintained at the highest standards.
• Consult, when necessary, with the Beneficiary's selected case management entity to generate an approvable service plan.
• Ensure that the randomly selected Service Plan completed by the Beneficiary's assigned case management entity is appropriate to the Beneficiary's unmet need for services, based on the severity of their medical condition, functional disability, physical, or cognitive impairment.
• Include an interview with family members and informal caregivers who are present at the time of the assessment.
• 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.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Qualifications:

• Registered Nurse (NC or Compact license)
• Minimum of two years of nursing experience.
• This position requires travel up to a 60 mile radius.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Experience in Lieu of Degree

For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree.

Compensation

The pay range for this position is listed below.

Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.

Pay Range: USD $67,300.00 - USD $93,050.00 /Yr.