Clinical Assessor; RN - Hybrid

Company Overview

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 a 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 to join our growing team.

• Conduct assessment 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.
• Complete new, expedited, annual, change of status, mediation/appeals, reconsideration review, and derivative assessments within established time frames.
• Include an interview with family members and informal caregivers present at the time of the assessment.
• Provide the Beneficiary with guidance and assistance, as necessary, to select PCS 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.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

• Registered Nurse or LCSW license by the applicable state.
• Minimum of two years of nursing experience.
• Travel up to a 60 mile radius required.

• Experience with community‑based individuals needing personal assistance with ADL and IADL tasks highly preferred.
• Experience conducting PCS assessments highly preferred.
• 2+ 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.
• Experience conducting HCBS waiver assessments highly preferred.
• Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual.
• Knowledge of standards of practice related to Medicaid‑funded Personal Care Services, home and community‑based services (HCBS) programs, and EPSDT.
• Knowledge and understanding of public sector services and supports.
• Computer proficiency in Microsoft Excel, Word and Outlook.
• Ability to utilize computer equipment and web‑based software to conduct work.
• Ability to interact with various office staff as needed to support necessary workflows.
• Ability to interact with healthcare professionals, patients, their families and other supports.
• Ability to communicate effectively to individuals and groups through spoken, written and electronic media.
• Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.
• Ability to work independently without a high degree of supervision.
• Develops level of care recommendations based upon clinical evaluations.
• Participates in training of PCS stakeholders as needed.
• Ability to use person‑centered thinking, planning, and have competency in awareness of the needs of persons with disabilities.

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers…