Clinical Assessor (RN - Hybrid)

Acentra Health; Fairmont (NC); Hybrid; USD 77,000 - 80,000; Full time

Job summary

A healthcare services company is looking for a Clinical Assessor in North Carolina. This hybrid role involves conducting assessments for Medicaid beneficiaries in the home or community setting. Candidates must hold a nursing license and have at least two years of experience. The position offers a competitive salary range of $77,000 - $80,000 annually, along with comprehensive benefits.

Benefits

Comprehensive health plans

Paid time off

Retirement savings

Corporate wellness

Educational assistance

Qualifications

• Minimum of two years of nursing experience required.
• Travel up to a 60 mile radius required.
• Registered Nurse or LCSW license by the applicable state.

Responsibilities

• Conduct assessments to determine PCS eligibility.
• Maintain privacy and dignity standards.
• Provide guidance to select PCS providers.

Skills

Registered Nurse or LCSW license

Nursing experience

Attention to detail

Effective communication

Computer proficiency

Education

State nursing license

Tools

Microsoft Excel

Microsoft Word

Outlook

Job description

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. It invites problem-solving, ownership of work, and accelerated career growth as a partner for health solutions in the public sector.

Position: Clinical Assessor (Hybrid) — candidates should be based within Cumberland and Robeson Counties, NC, to cover field work involved.

Job Summary and Responsibilities

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 with unmet needs for hands-on assistance with activities of daily living (ADLs). The PCS Assessor is responsible for completing needs-based eligibility determinations for North Carolinians applying for Medicaid-funded personal care services 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 who would be at risk without specialized Waiver services. Services are for situations where no household member, relative, caregiver, landlord, community agency, volunteer agency, or third-party payer can 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 help individuals 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 Cumberland and Robeson Counties of North Carolina to cover field work.

Responsibilities:

• Conducts assessments to determine whether the beneficiary meets conditions and criteria for PCS eligibility using state-approved standardized assessment tools.
• Ensure PCS is provided on a needs-basis in quantities appropriate to the beneficiary's unmet need for services based on severity of medical condition, functional disability, physical or cognitive impairment.
• Maintain the privacy and dignity of individuals receiving PCS assessments at the highest standards.
• Ensure that new, expedited, annual, change of status, mediation/appeals, reconsideration, and derivative assessments are conducted within established timeframes.
• Include interviews with family members and informal caregivers present at the time of the assessment.
• Provide guidance and assistance to the beneficiary to select PCS providers.
• Conduct service plan reviews as needed.
• Submit completed assessments using the 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, and internal auditing as assigned.
• Provide assessments for initial eligibility determinations for applicants to participate in a 1915(c) HCBS program, and, when applicable, annual and change of status assessments for participants in a 1915(c) HCBS program, using state-approved tools.
• Ensure CAP services are provided on a needs basis, aligned with the beneficiary's unmet needs and impairments.
• Maintain privacy and dignity of individuals receiving CAP assessments.
• Consult with the beneficiary's selected case management entity to generate an approvable service plan.
• Ensure that the Service Plan completed by the case management entity is appropriate to the beneficiary's needs.
• Include interviews with family members and informal caregivers as appropriate.
• Submit completed assessments using the state-approved interface.
• Participate in the beneficiary's mediation and appeal processes.
• Respond to state inquiries regarding assessments conducted.
• Attend and 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

Required Qualifications

• Registered Nurse or LCSW license by the applicable state.
• Minimum of two years of nursing experience.
• Travel up to a 60 mile radius required.

Preferred Qualifications

• Experience with community-based individuals needing personal assistance with ADL and IADL tasks is highly preferred.
• Experience conducting PCS assessments highly preferred.
• 2+ years of home healthcare experience preferred.
• 2+ years of directly-related experience (preferably case management) in health or medical field relevant to homecare, long-term care, or personal care is preferred.
• Experience conducting HCBS waiver assessments highly preferred.
• Knowledge of NC Medicaid Clinical Policy (Clinical Policy) 3L and PCS Program Provider Manual.
• Knowledge of standards of practice related to Medicaid-funded Personal Care Services, 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 to conduct work.
• Ability to interact with office staff, healthcare professionals, patients, families, and other supports.
• Ability to communicate effectively through spoken, written, and electronic media.
• Attention to detail, prioritization, and timely task execution.
• Ability to work independently with minimal supervision.
• Develops level of care recommendations based on clinical evaluations.
• Participates in PCS stakeholder training as needed.
• Ability to use person-centered thinking and planning; awareness of needs of persons with disabilities.
• Knowledge of NC Medicaid Clinical Policy 3K-1 and 3K-2, and 42 CFR Part 441 Subpart G, 42 CFR 440.180.
• Knowledge of LOC and Waiver Participation eligibility criteria.
• Knowledge of standards of practice related to Medicaid waivers, HCBS, EPSDT, medical fragility, and LOC determinations.
• Participates in CAP stakeholder training as needed.

Why us?

We are a team of experienced leaders, clinicians, pioneers, and industry professionals who redefine healthcare expectations. We partner with state and federal agencies, providers, and employers to improve healthcare and health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves lives across the country. We are a company that cares about employees and provides tools and encouragement to achieve excellent work.

Benefits

Benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

EEO

EEO AA M/F/Vet/Disability. Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, national origin, disability, veteran status, or any other status protected by law.

Compensation

Pay range: USD $77,000.00 - USD $80,000.00 /Yr. Based on experience and location.

Visit us at https://careers.acentra.com/jobs