Clinical Assessor, Mid

Acentra Health, LLC•Weirton, WV

About The Position

Acentra Health is seeking a Clinical Assessor to complete needs-based eligibility determinations for people applying for Medicaid-funded personal care services (PCS) in their homes, adult care homes, or supervised living homes. The role also assesses level of care to support eligible individuals in remaining in or returning to home- and community-based settings. Assessments are conducted with state-approved standardized tools and submitted through a state-approved interface. The position involves travel to various locations and may include driving for up to approximately eight hours in a day. It may require lifting up to 50 pounds. The Clinical Assessor must protect the privacy and dignity of people receiving assessments, comply with corporate policies including HIPAA privacy and security requirements, and participate in assessment-related mediation and appeal processes, meetings, consultations, peer reviews, and audits as assigned.

Requirements

Registered Nurse or LCSW license issued by the applicable state.
Valid driver's license.
Ability to travel to various locations, including driving for up to approximately eight hours in a day.
Ability to lift up to 50 pounds.

Nice To Haves

At least two years of experience in a home care setting is preferred.

Responsibilities

Conduct assessments using state-approved standardized tools to determine whether beneficiaries meet PCS eligibility criteria.
Ensure PCS are provided on a needs basis and in quantities appropriate to beneficiaries’ unmet needs, considering medical conditions and functional, physical, or cognitive impairments.
Maintain the privacy and dignity of individuals receiving PCS assessments.
Complete new, expedited, annual, change-of-status, mediation/appeals, reconsideration review, and derivative assessments within established timeframes.
Interview family members and informal caregivers present during assessments.
Guide and assist beneficiaries, as necessary, in selecting PCS providers.
Conduct service plan reviews as needed.
Submit completed assessments through the state-approved interface.
Participate in beneficiary mediation and appeal processes.
Respond to state inquiries about assessments conducted.
Attend and participate in staff meetings, and conduct case consultations, peer reviews, and internal audits as assigned.
Conduct initial eligibility assessments for applicants to 1915(c) HCBS programs and, when applicable, annual and change-of-status assessments for current participants, using state-approved standardized tools.
Read, understand, and follow corporate policies, including HIPAA Privacy and Security Rules.