RN Clinical Assessor

Acentra Health, LLC•Town of Winfield, OH

8d•Hybrid

About The Position

Acentra Health is looking for a RN Clinical Assessor (Aged & Disabled Waiver) to join their 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. RN Clinical Assessors must manage a caseload of assigned members to ensure that assessments are scheduled, appropriate persons are in attendance, assessments are performed, and data is entered into Atrezzo within prescribed timelines. This position requires extensive local travel within an assigned catchment area as well as periodic travel outside a catchment area. This is a hybrid role based in West Virginia, combining remote work from home with field assessments and quarterly in-office meetings. The ideal candidate will be centrally located in the state to best serve the catchment area.

Requirements

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

Nice To Haves

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

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
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)
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