About the position
Acentra Health is seeking Clinical Assessors to join our growing team in North Carolina. This role is pivotal in providing essential services under the Personal Care Services (PCS) program, which caters to NC Medicaid Beneficiaries who have medical conditions, cognitive impairments, or disabilities that necessitate hands-on assistance with activities of daily living (ADLs). As a Clinical Assessor, you will work from your home office and travel to various assessment locations within your region. Your primary responsibility will be to conduct needs-based eligibility determinations for individuals applying for Medicaid-funded personal care services, ensuring that they receive the appropriate level of care based on their unique needs. In addition to the PCS program, you will also be involved with the Community Alternatives (CAP) Program, which provides home and community-based waivers as cost-neutral alternatives to institutionalization for beneficiaries at risk of being placed in such facilities. Your assessments will play a crucial role in determining the level of care required for individuals to remain in or return to a home and community-based setting. This position requires a commitment to maintaining the privacy and dignity of individuals during assessments, as well as ensuring that services are provided based on a thorough understanding of each beneficiary's medical, psychosocial, and functional needs. As a Clinical Assessor, you will conduct assessments using state-approved standardized tools, engage with family members and informal caregivers during the assessment process, and provide guidance to beneficiaries in selecting appropriate PCS providers. You will also be responsible for submitting completed assessments through the state-approved interface and participating in mediation and appeal processes as needed. Your role will involve attending staff meetings, conducting case consultations, and participating in internal audits to ensure compliance with established standards and practices.
Responsibilities
- Conduct assessments to determine PCS eligibility using state-approved standardized assessment tools.
- Ensure PCS are provided based on the beneficiary's unmet needs for services.
- Maintain the privacy and dignity of individuals receiving assessments.
- Conduct assessments within established timeframes, including expedited and annual assessments.
- Interview family members and informal caregivers present during assessments.
- Provide guidance to beneficiaries in selecting PCS providers.
- Conduct service plan reviews as needed.
- Submit completed assessments using state-approved interface.
- Participate in mediation and appeal processes for beneficiaries.
- Respond to state inquiries regarding assessments conducted.
- Attend and actively participate in staff meetings and conduct case consultations/peer reviews/internal auditing as assigned.
Requirements
- Registered Nurse or LCSW license by the state of North Carolina.
- 2+ years of experience in a home care setting preferred.
Nice-to-haves
- Experience with community-based individuals needing personal assistance with ADL and IADL tasks is highly preferred.
- Experience conducting PCS assessments highly preferred.
- 2+ years of directly-related experience in the health or medical field, preferably in case management related to homecare, long-term care, or personal care.
- Experience conducting HCBS waiver assessments highly preferred.
- Knowledge of North Carolina Medicaid Clinical Coverage Policy and PCS Program Provider Manual.
- Knowledge of standards of practice related to Medicaid-funded Personal Care Services and HCBS programs.
- Knowledge and understanding of public sector services and supports.
- Computer proficiency in Microsoft Excel, Word, and Outlook.
