Clinical Assessor - RN (Hybrid/Travel) - Vance County, NC in Oxford

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.

Acentra Health is looking for a Clinical Assessor to join our growing team. The position is hybrid, and candidates should be based within Vance County of North Carolina (Henderson, NC & surrounding cities) to cover the field work involved.

Responsibilities:

• Conduct assessments to determine whether the beneficiary meets the conditions and criteria for PCS eligibility, using state-approved standardized assessment tool(s).
• Ensure that 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.
• Maintain the privacy and dignity of individuals receiving assessment for PCS at the highest standards.
• Conduct new, expedited, annual, change of status, mediation/appeals, reconsideration review, and derivative assessments within established timeframes.
• Include interviews with family members and informal caregivers present at the time of the assessment.
• Provide guidance and assistance to the Beneficiary in selecting PCS providers.
• Conduct service plan reviews as needed.
• Submit 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.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Qualifications:

• Registered Nurse (NC or Compact license).
• Minimum of two years of nursing experience.
• This position requires travel up to a 60-mile radius.
• Experience with community-based individuals needing personal assistance with ADL and IADL tasks is highly preferred.
• Experience conducting PCS assessments highly preferred.
• 2+ years of home healthcare experience preferred.
• 2+ years of directly-related experience (preferably case management) in the health or medical field, directly related to homecare, long-term care, or personal care is preferred.
• Knowledge of North Carolina Medicaid Clinical Coverage Policy and standards of practice related to Medicaid-funded Personal Care Services.
• Computer proficiency in Microsoft Excel, Word, and Outlook.
• Ability to communicate effectively to individuals and groups through spoken, written, and electronic media.
• Ability to work independently without a high degree of supervision.

Benefits:

Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

The pay range for this position is USD $67,300.00 - USD $93,050.00 /Yr.

Thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted.