Commission Rn Insurance Assessment Jobs in Beckley, WV

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 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 that assessments are scheduled, appropriate persons are in attendance, assessments are performed, and data is entered into Atrezzo within prescribed timelines. This position requires extensive local travel within an assigned catchment area as well as periodic travel outside a catchment area.

*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 that is centrally located in the state to best serve the catchment area. The following towns are examples: Charleston, Teays Valley, Winfield, Elkview, Ripley.

Responsibilities:

• 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 assessment 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 need for services based on the severity of their 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 timeframes
• Include an interview with family members and informal caregivers who are 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 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
• 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)
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Required qualifications:

• Valid, unrestricted Registered Nurse (RN) license for the state of West Virginia or compact license
• Must have a valid driver's license and access to reliable transportation
• Willingness to travel to homes and facilities within the catchment area (travel outside one's catchment area is occasionally required to fill-in for others or to attend staff meetings/events)
• Candidate should be organized and have excellent customer service skills, good interpersonal communication and be flexible
• Applicant must be able to accurately assess medical conditions and symptoms and functional abilities
• Applicant must possess computer skills, specifically with Microsoft Outlook, Microsoft Word, Microsoft Edge, Google Chrome

Preferred qualifications:

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

Why us?

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 turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Experience in Lieu of Degree

For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at https://careers.acentra.com/jobs

EEO AA M/F/Vet/Disability

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.

Compensation

The pay range for this position is listed below.

"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

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