Clinical Assessor FT, - RN (Hybrid/Travel) Robeson County, NC

About the role

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. We embrace emerging technologies, including artificial intelligence and advanced analytics, to improve processes, enhance decision-making, and drive better health outcomes.

The purpose of this position is to complete needs-based eligibility determinations for patients applying for Medicaid-funded personal care services provided in their home or in adult care or supervised living homes. This role also assesses level of care (LOC) to allow targeted individuals to remain in or return to a home and community-based setting. This position requires a valid driver's license and travel to various locations, which may include extended periods of driving (up to approximately 8 hours in a day and up to 120 miles a day). Travel expenses—including mileage and parking—are covered and reimbursed by Acentra Health. All necessary technology equipment for your home office, including a laptop for use in the field, will be provided.

Responsibilities

• 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.
• 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.
• 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.

Requirements

• Registered Nurse (NC or Compact license)
• Minimum of two years of nursing experience
• This position requires travel up to 120 miles roundtrip

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 the health or medical field, directly related to homecare, long-term care, or personal care is preferred
• Experience conducting HCBS waiver assessments highly preferred