PRN - RN Clinical Assessor (Aged & Disabled Waiver)

About the role

Acentra Health is seeking a PRN - RN Clinical Assessor (Aged & Disabled Waiver) to join our growing team. 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 Aged & Disabled Waiver Program.

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 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.
• 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

• Valid, unrestricted Registered Nurse (RN) license for the state of West Virginia or compact license.
• Must have a valid 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.
• 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 Aged and Disabled Waiver Program).
• Knowledge of the Aged and Disabled Waiver program policies and procedures.

Benefits

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.