RN Clinical Assessor – Home Care Eligibility

Acentra Health; Williamstown (WV); On-site; USD 67,000 - 70,000; Full time

Benefits offered by this job

Comprehensive health plans

Paid time off

Retirement savings

Corporate wellness

Educational assistance

Corporate discounts

Job summary

Acentra Health is seeking a Clinical Assessor, Mid to join our growing team. The role focuses on completing needs-based eligibility determinations for Medicaid-funded personal care services and assessing level of care to keep clients in home- and community-based settings.

Travel to various locations is required, with days that may include extended driving. You will work to maintain privacy, adhere to HIPAA, and support assessment processes across multiple programs and settings.

Qualifications

• Must have RN license in the applicable state.
• Minimum of two years' experience in a home care setting preferred.
• Valid driver's license and willingness to travel to various locations.

Responsibilities

• Conduct assessments to determine whether the beneficiary meets the conditions and criteria for ADW eligibility, using state-approved standardized assessment tool(s).
• Ensure ADW 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.
• Ensure the privacy and dignity of individuals receiving assessment for ADW is maintained at the highest standards.
• Ensure 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 ADW 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 participants currently participating in a 1915(c) HCBS program, using state-approved standardized assessment tool(s).
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Skills

Driver's license

Education

Registered Nurse license

Job description

Acentra Health is seeking a Clinical Assessor, Mid to join our growing team. The role focuses on completing needs-based eligibility determinations for Medicaid-funded personal care services and assessing level of care to keep clients in home- and community-based settings.

Travel to various locations is required, with days that may include extended driving. You will work to maintain privacy, adhere to HIPAA, and support assessment processes across multiple programs and settings.