Clinical Assessor, Mid

Acentra Health, LLC•Town of Ripley, NY

About The Position

Acentra Health is seeking a Clinical Assessor to complete needs-based eligibility determinations for patients applying for Medicaid-funded personal care services in their homes, adult care homes, or supervised living homes. The role also assesses level of care to help targeted individuals remain in or return to home and community-based settings. The assessor uses state-approved standardized assessment tools to determine eligibility for ADW and 1915(c) HCBS programs, and conducts applicable annual, change-of-status, expedited, and other assessments and reviews. The role involves traveling to various locations, potentially driving for up to approximately eight hours in a day, and may require lifting up to 50 pounds. A valid driver's license is required. The position requires a Registered Nurse license issued by the applicable state. At least two years of home care experience is preferred.

Requirements

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

Nice To Haves

Minimum of two years' experience in a home care setting.

Responsibilities

Conduct assessments using state-approved standardized assessment tools to determine whether beneficiaries meet the conditions and criteria for ADW eligibility.
Ensure ADW services are provided on a needs basis and in quantities appropriate to beneficiaries' unmet needs and the severity of their medical conditions, functional disabilities, or physical or cognitive impairments.
Maintain the privacy and dignity of individuals receiving assessments to the highest standards.
Complete new, expedited, annual, change-of-status, mediation/appeals, reconsideration review, and derivative assessments within established timeframes.
Include interviews with family members and informal caregivers who are present at the time of assessment.
Provide beneficiaries with guidance and assistance, as necessary, to select ADW providers.
Conduct service plan reviews as needed.
Submit completed assessments using the state-approved interface.
Participate in beneficiary mediation and appeal processes.
Respond to state inquiries regarding assessments conducted.
Attend and actively participate in staff meetings, and conduct case consultations, peer reviews, and internal auditing as assigned.
Provide 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 assessment tools.
Read, understand, and adhere to corporate policies, including HIPAA Privacy and Security Rules.