Clinical Assessor - RN (Hybrid - Travel Required) - PRN

Acentra Health, LLC; Charlotte (NC); On-site; USD 60,000 - 80,000; Full time

Job summary

Acentra Health, LLC is seeking a Clinical Assessor to join our NC-based team. The role requires nurse licensure (NC or Compact) and at least two years of nursing experience, with travel across a Mecklenburg County/Charlotte region.

The assessor will perform needs-based eligibility determinations under PCS and CAP programs, often in the beneficiary's home, and will work in a hybrid schedule with local field responsibilities.

Qualifications

• RN license required (NC or Compact)
• Minimum of two years nursing experience
• Travel up to 60 miles radius

Responsibilities

• Conduct PCS/CAP assessments to determine eligibility for Medicaid-funded services.
• Interview beneficiaries and family members to collect information and assess needs.
• Ensure privacy and dignity of individuals during assessments and interactions.
• Submit completed assessments using state-approved interface and adhere to timelines.
• Coordinate with case management and providers to support approved service plans.

Education

Registered Nurse license (NC or Compact)

Job description

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. 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.

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 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 Mecklenburg County, NC (Charlotte) 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

Required Qualifications

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

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.