RN 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.

At Acentra Health, we embrace emerging technologies, including artificial intelligence and advanced analytics that can be utilized to improve processes, enhance decision-making, and drive better health outcomes. We value professionals who are curious about new technologies and motivated to use innovative tools to increase efficiency, quality, and impact in their roles.

Job Summary and Responsibilities

Acentra Health is looking for a RN Clinical Assessor (Personal Care) to join our growing team.:

Job Summary

This position educates and performs medical eligibility assessments of WV Medicaid recipients seeking community-based services and follows prescribed guidelines while administering the Pre-Admission Screening for determination of medical eligibility for the Personal Care Program and the Aged & Disabled Waiver Program. Personal Care RNs must manage a caseload of assigned members to ensure that assessments are scheduled, appropriate persons are in attendance, assessments are performed, and data is entered into Atrezzo within prescribed timelines. This position requires extensive local travel within an assigned catchment area as well as periodic travel outside a catchment area

*This hybrid role is based in West Virginia and combines remote work from home with field assessments and quarterly in-office meetings. For optimal field coverage, Applicants should reside in Lewis, Barbour, Upshur, Randolph, Pocahontas, or Pendleton County.

Responsibilities

• Document contacts, schedule appointments, travel to conduct and appropriately administer/document Pre-Admission Screening assessments within prescribed timelines
• Participate in inter-rater reliability activities to ensure consistent administration of assessments and adherence to assessment protocols Participate in denial hearings as necessary
• Contact physicians and facilities to confirm medical information
• Conduct assessments to determine whether the beneficiary meets the conditions and criteria for PCS eligibility, using state-approved standardized assessment tool(s)
• Ensure 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
• Ensure the privacy and dignity of individuals receiving assessment for PCS 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 PCS providers
• Submit the completed assessments using state-approved interface
• Participate in the Beneficiary's mediation and appeal processes
• 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

• Valid, unrestricted Registered Nurse (RN) license for the state of West Virginia or compact license
• Associate of Science in Nursing (ASN) degree from an accredited college/university (BSN preferred)
• Must have a valid West VA driver's license and access to reliable transportation
• Willingness to travel to homes and facilities within the catchment area (travel outside one's catchment area is occasionally required to fill-in for others or to attend staff meetings/events)
• Candidate should be organized and have excellent customer service skills, good interpersonal communication and be flexible
• Applicant must be able to accurately assess medical conditions and symptoms and functional abilities
• Applicant must possess computer skills, specifically with Microsoft Outlook, Microsoft Word, Microsoft Edge, Google Chrome

Preferred qualifications

• Two years of experience in a home care setting
• Two years of experience with the aging population or with persons with disabilities (preferably working within the WV Personal Care program)
• Knowledge of the Personal Care and Aged and Disabled Waiver program policies and procedures

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.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

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

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.

"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."

USD $67,300.00 - USD $72,000.00 /Yr.

Required qualifications

• Valid, unrestricted Registered Nurse (RN) license for the state of West Virginia or compact license
• Associate of Science in Nursing (ASN) degree from an accredited college/university (BSN preferred)
• Must have a valid West VA driver's license and access to reliable transportation
• Willingness to travel to homes and facilities within the catchment area (travel outside one's catchment area is occasionally required to fill-in for others or to attend staff meetings/events)
• Candidate should be organized and have excellent customer service skills, good interpersonal communication and be flexible
• Applicant must be able to accurately assess medical conditions and symptoms and functional abilities
• Applicant must possess computer skills, specifically with Microsoft Outlook, Microsoft Word, Microsoft Edge, Google Chrome

Preferred qualifications

• Two years of experience in a home care setting
• Two years of experience with the aging population or with persons with disabilities (preferably working within the WV Personal Care program)
• Knowledge of the Personal Care and Aged and Disabled Waiver program policies and procedures

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.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

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

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.

"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."