Clinical Assessor, Mid

About the role

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. The mission is to innovate health solutions that deliver maximum value and impact. The company embraces emerging technologies, including artificial intelligence and advanced analytics, to improve processes, enhance decision-making, and drive better health outcomes.

The Clinical Assessor, Mid completes 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. The 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). The role may require lifting up to 50 pounds.

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.

Qualifications

• Registered Nurse license by the applicable state.
• Minimum of two years' experience in a home care setting preferred.
• For non-clinical roles, or when not required by the contract specifically, the company accepts a minimum of six (6) years of directly relevant professional experience in lieu of a Bachelor's degree. With an Associate's degree, a minimum of three (3) years of directly relevant professional experience is accepted in lieu of the Bachelor's degree.

Benefits

• Comprehensive health plans
• Paid time off
• Retirement savings
• Corporate wellness
• Educational assistance
• Corporate discounts

Pay

Based on the 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. Pay Range: USD $67,300.00 - USD $70,000.00 /Yr.