Jobs · West Virginia

RN Clinical Assessor

Acentra Health · Madison, WV · Yesterday
$67k/yrFull-time

About the role

Acentra Health is seeking a 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
  • 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

Preferred Qualifications

  • Minimum of two years' experience in a home care setting
  • Minimum of two years' experience with 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

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