Clinical Assessor RN Specialist

6 days ago

Warsaw, Indiana, United States KEPRO Full time
Job Summary

The Clinical Assessor RN will be responsible for conducting needs-based eligibility determinations for patients applying for Medicaid-funded personal care services. This position will also assess the level of care to allow targeted individuals to remain in or return to a home and community-based setting.

Key Responsibilities
  • Conduct assessments to determine whether beneficiaries meet the conditions and criteria for PCS eligibility using state-approved standardized assessment tools.
  • Ensure that CAP or 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 CAP or PCS at the highest standards.
  • Conduct new, expedited, annual, change of status, mediation/appeal, and reconsideration reviews within established timeframes.
  • Ensure that randomly selected Service Plans completed by the beneficiary's assigned case management entity are appropriate to the beneficiary's unmet need for services based on the severity of their medical condition, functional disability, physical, or cognitive impairment.
  • Include an interview with family members and informal caregivers who are present at the time of the assessment.
  • Provide beneficiaries with guidance and assistance, as necessary, to select CAP or PCS providers.
  • Submit completed assessments using state-approved interfaces.
  • Participate in the beneficiary's mediation and appeal processes.
  • 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 participants currently participating in a 1915(c) HCBS program using state-approved standardized assessment tools.
Requirements
  • Registered Nurse license by the applicable state.
  • Preferred qualifications include two years of experience in a home care setting.
Why Choose Acentra Health?

Acentra Health is a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. We are a vital partner for health solutions in the public sector, and we offer unparalleled opportunities for our employees.

As a Clinical Assessor RN, you will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement you need to achieve the finest work of your career.

We are an Equal Opportunity Employer and welcome applications from diverse candidates. Our benefits package includes comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

The pay range for this position is $51,780-88,500, based on our compensation philosophy, which considers various factors, including years of applicable experience and skill level.

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