Clinical Assessor - RN (Hybrid in NC - Travel Required)

Company Overview 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. You have all you need to take charge of your career and accelerate better outcomes. Job Summary Acentra Health is looking for a Clinical Assessor to join our growing team. The role involves working from a home office and traveling to assessment locations in North Carolina. The PCS Assessor determines eligibility for NC Medicaid beneficiaries; the CAP Assessor performs needs‑based assessments for individuals at risk of institutionalization. The position is hybrid and candidates should be based within Davidson and Randolph County. Responsibilities Conduct assessments to determine beneficiary eligibility for PCS or CAP programs using state‑approved tools. Ensure services are provided on a needs basis in quantities appropriate to the beneficiary’s unmet needs. Maintain privacy and dignity of individuals during assessments. Complete new, expedited, annual, change‑of‑status, mediation, appeal, reconsideration, and derivative assessments within established timeframes. Interview family members and informal caregivers present at the assessment. Provide guidance to beneficiaries for selecting PCS providers and conduct service plan reviews. Submit completed assessments using approved interfaces and respond to state inquiries. Participate in mediation and appeal processes. Attend staff meetings, case consultations, peer reviews, and internal auditing as assigned. Provide assessments for initial eligibility determinations and ongoing assessments for 1915(c) HCBS programs. Apply for case management consultation and ensure service plans are appropriate. Read and adhere to corporate policies, including HIPAA privacy and security rules. Qualifications Required Qualifications Registered Nurse (NC or Compact license) Minimum of two years of nursing experience Ability to travel up to a 60‑mile radius Preferred Qualifications Experience with community‑based individuals needing personal assistance with ADL and IADL tasks Experience conducting PCS assessments 2+ years of home healthcare experience 2+ years of directly related experience in health, medical, homecare, long‑term care, or personal care Experience conducting HCBS waiver assessments Knowledge of North Carolina Medicaid Clinical Coverage Policy 3L and PCS Program Provider Manual Knowledge of standards of practice for Medicaid‑funded Personal Care Services and HCBS programs, and EPSDT Knowledge of public sector services and supports Computer proficiency in Microsoft Excel, Word, and Outlook Ability to use computer equipment and web‑based software Strong interpersonal skills with office staff, healthcare professionals, patients, families, and supports Effective communication skills in spoken, written, and electronic media Attention to detail, prioritization, and task execution in a timely manner Ability to work independently without high supervision Develop level of care recommendations based on clinical evaluations Participate in training of PCS stakeholders Use person‑centered thinking, planning, and awareness of the needs of people with disabilities Knowledge of North Carolina Medicaid Clinical Policies 3K‑1, 3K‑2, 42 CFR Part 441 Subpart G, and 440.180 Knowledge of eligibility criteria for levels of care and waiver participation Knowledge of standards of practice for Medicaid waivers, HCBS programs, EPSDT, medical fragility, and level of care determinations Participate in training of CAP stakeholders Benefits Comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. #J-18808-Ljbffr Acentra Health