RN Clinical Assessor

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 a rallying cry at Acentra Health. It invites staff to embrace the company mission, engage in problem‑solving, and take ownership of their work every day. The company offers unparalleled opportunities for career acceleration and meaningful impact in the public sector.

Acentra Health is looking for a RN Clinical Assessor (Aged & Disabled Waiver) to join our growing team.

Job Summary: 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 assessments are scheduled, appropriate persons are present, assessments are performed, and data is entered into Atrezzo within prescribed timelines.

Extensive local travel within an assigned catchment area, with occasional travel outside that area, is required.

* This is a hybrid role based in West Virginia, combining remote work from home with field assessments and quarterly in‑office meetings. We are seeking someone centrally located within the state (e.g., Charleston, Teays Valley, Winfield, Elkview, Ripley) to best serve the catchment area.

• 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 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 needs based on the severity of 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 time frames.
• Include an interview with family members and informal caregivers who are present at the time of the assessment.
• Provide beneficiaries with guidance and assistance to select ADW providers, as necessary.
• Conduct service plan reviews as needed.
• Submit completed assessments using the 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; conduct case consultations, peer reviews, and internal auditing as assigned.
• Provide assessments for initial eligibility determinations for applicants to participate in a 1915(c) HCBS program, and, when applicable, annual and change of status assessments for current participants, using state‑approved standardized assessment tool(s).
• Read, understand, and adhere to all corporate policies, including those related to HIPAA and its Privacy and Security Rules.

• Valid, unrestricted Registered Nurse (RN) license for the state of West Virginia or a compact license.
• Valid driver’s license and reliable transportation.
• Willingness to travel to homes and facilities within the catchment area (occasional travel outside the area is required to support other staff or attend meetings).
• Organized, customer‑service oriented, with strong interpersonal communication and flexible.
• Ability to accurately assess medical conditions, symptoms, and functional abilities.
• Computer skills, specifically with Microsoft Outlook, Word, Edge, and Google Chrome.