Clinical Assessor, Mid - RN - Full-time (Remote U.S.)

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.

Acentra Health is looking for a Clinical Assessor, Mid to join our growing team. Job Summary: The purpose of this position is to complete needs-based level of care (LOC) determinations and exception requests for service authorizations for members applying for Medicaid Waiver services. This position also assesses level of care (LOC) to allow targeted individuals to remain in or return to a home and community-based setting.

Conduct assessments to determine whether the beneficiary meets the conditions and criteria for Waiver eligibility, using state-approved standardized assessment tool(s). Ensure the privacy and dignity of individuals receiving assessment for Waiver services 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. Conduct service plan reviews as needed. Submit the completed assessments using state-approved interface. Participate in the Member's mediation and appeal processes, as requested. 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). Consult, when necessary, with the Member's selected Case Management entity to generate an approvable service plan. Ensure that the selected service plan completed by the Member's assigned Case Manager is appropriate to the Member's need for services, based on the severity of their medical condition, functional disability, physical, or cognitive impairment. Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.