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.

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. The role includes managing a caseload of assigned members, scheduling assessments, ensuring data entry into Atrezzo within prescribed timelines, and extensive local travel within an assigned catchment area.

This is a hybrid role based in West Virginia, combining remote work from home with field assessments and quarterly in-office meetings. Candidates should be centrally located in the state to best serve the catchment area (e.g., Charleston, Teays Valley, Winfield, Elkview, Ripley).

• Document contacts, schedule appointments, and travel to conduct and appropriately administer/pre‑admission screening assessments within prescribed timelines.
• Participate in inter‑rater reliability activities to ensure consistent administration of assessments and adherence to assessment protocols.
• 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 tools.
• 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, or cognitive impairment.
• Maintain the privacy and dignity of individuals receiving ADW assessment at the highest standards.
• Conduct new, expedited, annual, change‑of‑status, mediation/appeal, reconsideration, 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 ADW providers.
• 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, case consultations, peer reviews, and internal audits as assigned.
• Provide assessments for initial eligibility determinations for 1915(c) HCBS program participants and, when applicable, annual and change‑of‑status assessments for current participants.
• 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 access to reliable transportation.
• Willingness to travel to homes and facilities within the catchment area (travel outside the catchment area occasionally required).
• Organized, with excellent customer‑service skills, good interpersonal communication, and flexibility.
• Ability to accurately assess medical conditions, symptoms, and functional abilities.
• Computer skills, specifically with Microsoft Outlook, Microsoft Word, Microsoft Edge, and Google Chrome.

• Minimum of two years' experience in a home‑care setting.
• Minimum of two years' experience with an aging population or persons with disabilities, preferably within the WV Aged and Disabled Waiver Program.
• Knowledge of the Aged and Disabled Waiver program policies and procedures.

Benefits are a key component of your rewards package, including comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

USD $67,300.00 - USD $68,915.00 per year.

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.