RN Clinical Assessor (Gaston and Cleveland counties)

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. 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.

The purpose of this position is to complete needs-based eligibility determinations for patients who are applying for Medicaid-funded personal care services provided in their home or in adult care or supervised living homes. This position also assesses level of care (LOC) to allow targeted individuals to remain in or return to a home and community-based setting. This position is hybrid, combining remote work from home with field-based responsibilities including face to face assessment visits to homes and assisted living facilities. Candidates must reside in one of the designated North Carolina counties to support required fieldwork. Travel may extend up to 60 miles in any direction from the employee’s home base, with the potential to drive up to 220 miles or more in a day.

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.

Qualifications

• Registered Nurse (RN) license for the State of North Carolina or compact multi-state
• A valid driver’s license and reliable transportation

Preferred qualifications:

• 2+ years of experience in a home care setting
• Computer proficiency in using Microsoft Office Suite

Experience in lieu of degree: 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