Acentra Health

Title: Clinical Reviewer Behavioral Health Location: United States - Full-Time - Remote within the United States - Regular - 5795 Job Description: 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 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. Job Summary and Responsibilities Acentra Health is looking for a Clinical Reviewer of Behavioral Health to join our growing team. Job Summary: The purpose of this position is to review medical records against appropriate criteria in conjunction with contract requirements to determine medical appropriateness. This position is remote within the United States but will be expected to work during Eastern time zone. Responsibilities: - Assures accuracy and timeliness of all applicable review type cases within contract requirements - Assesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department - In collaboration with Supervisor, responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas - Maintains current knowledge base related to review processes and clinical practices related to the review processes, functions as the initial resource to nurse reviewers regarding all review process questions and/or concerns - Functions as providers' liaison and contact/resource person for provider customer service issues and problem resolution - Performs all applicable review types as workload indicates - Fosters positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the review process - Attends training and scheduled meetings and for maintenance and use of current/updated information for review - Cross trains and perform duties of other contracts to provide a flexible workforce to meet client/customer needs - Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rule Qualifications Required qualifications: - Active and unrestricted license for the State of Virginia as a Registered Nurse (RN) OR Licensed Mental Health Professional (LMHP) such as Licensed Clinical Psychologist (LCP), Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), Licensed Substance Abuse Treatment Practitioner (LSATP), Licensed Marriage and Family Therapist (LMFT) - Associate's degree or higher from an accredited college or university in a related field - 1+ year of experience in Prior Authorization, Utilization Review, or Utilization Management - 3+ years of direct experience in a clinical setting or other applicable State clinical experience - Must be able to work weekends if needed (advance notification will be provided) Preferred qualifications: - Bachelor's degree or higher from an accredited college or university in a related field - Knowledge of the organization of medical records, medical terminology, and disease process - Strong clinical assessment and critical thinking skills - Requires excellent written and verbal communication skills - Medical record abstracting skills 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. 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." 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! 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. #LI-AF1 Pay Range USD $28.37 - USD $39.19 /Hr.

Title: Project Billing Analyst, Senior Location: United States Job Description: 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 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. Job Summary and Responsibilities Acentra Health is looking for a Senior Project Billing Analyst to join our growing team. Job Summary: The Senior Project Billing Analyst is responsible for the accurate preparation, review, and submission of invoices for federal and state contracts. Working within a compliance-driven environment, this role ensures billing aligns with contract terms, FAR/DFARS regulations, and internal policies. By partnering with project teams and finance leadership, the analyst helps manage the revenue cycle and maintain financial integrity across Acentra Health's government contracts. - The role is fully remote within the U.S., aligned to Eastern Time business hours with some flexibility. Responsibilities: - Prepare and submit accurate invoices for federal and state contracts, including CPFF, T&M, and FFP types - Review billing requirements and contract terms to ensure compliance with FAR, DFARS, and internal controls - Collaborate with project managers and contract administrators to track funding, deliverables, and contract modification - Reconcile and maintain the unbilled schedule to ensure timely revenue recognition - Monitor accounts receivable aging and follow up on outstanding balances with internal or government points of contact - Analyze billing data to identify and resolve discrepancies in coordination with clients or internal teams - Maintain complete and accurate documentation for all billing activities and support audit or DCAA inquiries - Assist with month-end close activities, including revenue accruals and reporting - Support the preparation of billed/unbilled revenue reports and incurred cost submissions - Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. Qualifications Required Qualifications - Bachelor's degree in accounting, finance, or a related field (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 candidates have an associate's degree, the company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the associate's degree.) - Minimum of 5 years of billing experience - In-depth knowledge of contract types: CPFF, T&M, FFP - Working knowledge of FAR, DFARS, and DCAA procedures - Familiarity with indirect rate structures and cost allocation - Hands-on experience with Deltek Costpoint or similar ERP systems - Strong Excel skills (e.g., pivot tables, VLOOKUPs) - High attention to detail, analytical mindset, and organizational skills Preferred Qualifications - Experience supporting Incurred Cost Submissions (ICS) - Exposure to revenue recognition principles and month-end close processes - Prior involvement in internal or external audit support 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. 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." #LI-AF1 Pay Range USD $67,760.00 - USD $84,700.00 /Yr.

Title: Clinical Evaluator (PRN) KS Location: Topeka United States Job Description: Part-Time Hybrid PRN 5577 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 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. Job Summary and Responsibilities Job Summary Join Acentra Health as a PASRR Evaluator in Kansas. In this role, you will conduct PASRR Level II Pre-Admission Screening and Resident Review assessments in Topeka, and the surrounding areas, make level-of-care recommendations, and help ensure the delivery of quality care that meets industry standards and complies with applicable government regulations. This PRN hybrid position offers the flexibility to work remotely from your home office while also traveling locally to complete in-person assessments. Travel expenses, including paid mileage and parking, are fully reimbursed. Your work will play a vital role in guiding care decisions and improving patient well-being and health outcomes. Acentra Health also provides the essential technology and equipment needed for both remote and field-based work, including a company-issued laptop. Job Responsibilities - Complete accurate PASRR Level II assessments by reviewing relevant records, gathering information from collateral sources, and evaluating the individual’s physical, behavioral, and psychological functionings. - Responsible for Preadmission Screening and Resident Review (PASRR) assessments, develop informed and evidence-based level-of-care recommendations and determine the most appropriate next level of care for individuals who may require long-term care placement. - Review and verify medical records and provide clinical recommendations in accordance with regulatory requirements, including evaluating psychiatric input, physician notes and meeting established turnaround time standards. - Interact with healthcare professionals, patients, their families, and internal partners as needed to support the assessment and review process. - Leverage technology, computer systems, web-based applications, and proprietary software platforms to efficiently perform job functions and manage and track assessment activities. - Ensure compliance with established workflows and complete assessments in a timely manner and within scope of practice to meet all contractual and program requirements. - Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. Qualifications Required Qualifications, Knowledge, and Experience - Must hold an active, unrestricted Kansas license in a healthcare or related discipline, including but not limited to Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Licensed Marriage and Family Therapist (LMFT), Licensed Independent Clinical Social Worker (LICSW), Licensed Clinical Professional Counselor (LCPC), Licensed Clinical Psychologist (LCP), Registered Nurse (RN) with a Specialty in Psychiatric Care, or another qualified Licensed Mental Health Professional (LMHP). - Graduation from an accredited college or university with a degree in a relevant field, along with a minimum of 3 years of experience in the assessment and/or diagnosis of individuals with mental or psychiatric disorders, including complex differential diagnoses involving substance use, medical conditions, cognitive impairment, dementia or geriatric populations. - Minimum of 2 years of experience working with individuals with intellectual and developmental disabilities, serious mental illness, or related conditions. - Proficiency in medical record abstraction and review. - Strong clinical judgment, evidence-based assessment, and critical-thinking skills. - Excellent interpersonal, verbal, and written communication skills, with the ability to communicate clearly and effectively with individuals and groups across spoken, written, and electronic formats. Preferred Qualifications - Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual of Mental Disorders (DSM) adopted by the applicable state. - Knowledge of best practices related to mental health, intellectual and developmental disabilities, geriatrics, and other conditions commonly requiring long-term care services and supports. - Knowledge of medical record structure, medical terminology, and disease processes. - Strong organizational skills, attention to detail, and the ability to manage priorities and complete work accurately within established timelines. - Experience working with the geriatric population preferred. - Proficiency in Microsoft Office Suite, including Excel, Word, PowerPoint, Outlook, and Teams, as well as experience using other web-based tools and platforms. 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 nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career. 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! 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 compensation for this role is $39.00 to $42.00 per hour Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level. #LI-JS1

Title: Clinical Assessor-PRN Locations: Durham, North Carolina; Raleigh, North Carolina; Morrisville, North Carolina; Cary, North Carolina; Rougemont, North Carolina; Chapel Hill, North Carolina Work Type: Hybrid, Full Time Job ID: 5417 Job Description: 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. Job Summary and Responsibilities Acentra Health is looking for a Clinical Assessor to join our growing team. - Acentra Health is seeking clinical assessors statewide in North Carolina for an exciting opportunity. You work out of your home office and travel to assessment locations in your region. Under the Community Alternatives (CAP) Program, home and community-based waivers provide cost-neutral alternatives to institutionalization for Beneficiaries, in specified target populations, who would be at risk for institutionalization if specialized Waiver services are not available. Services are intended for situations where no household member, relative, caregiver, landlord, community agency, volunteer agency, or third-party payer is able or willing to meet the assessed and required medical, psychosocial, and functional needs of the approved CAP Beneficiary. The CAP Assessor is responsible for the completion of needs-based eligibility determinations for North Carolinians who are applying for these Medicaid-funded personal care services provided in their home or in adult care or supervised living homes. - The CAP Assessor is responsible for completion of needs-based assessments of level of care (LOC) to allow targeted individuals to remain in or return to a home and community-based setting. Assessments are generally performed in the beneficiary's primary residence. - Daily tasks include processing CAP SRFs (services referral forms). If there are inquiries related to SRF processing, initiate RAIs (Requests for Additional Information) exclusively for SRFs that have been pending for three days or less. In cases where an SRF is missing the required information, issue a Technical Denial (TD) and document the reasons in the communication log. Monitor the CAP SRF queue each day to comply with the contract's stipulation of a maximum of 14 business days in the queue. Prior to processing SRFs, check for potential duplicate beneficiaries. Additionally, complete CAP SRF 2nd level when necessary. - Position is hybrid. Candidates should be based within Durham County of North Carolina to be able to cover the field work involved. This position is PRN. Responsibilities: - Your primary role will be completing CAPDA and CAPC comprehensive assessments. - You may also receive cross‑training in up to four additional areas, - Minimum Hours: 16 - Training Requirements: - Training may span up to seven (7) consecutive days. Includes up to four (4) days of remote learning followed by three (3) days of field training. - Travel Expectations: - Travel time for two assessments can be up to 120 miles per day - If travel exceeds 120 miles, the schedule will be reduced to one assessment. - PRN staff are not scheduled on Saturdays - Durham NC and surrounding counties in Region 4 - A two‑week advance schedule is required to allow sufficient time for appointment scheduling. The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time. Qualifications Required Qualifications - Registered Nurse or LCSW license by the applicable state. - Minimum of two years of nursing experience. - This position requires travel up to a 60-mile radius. Preferred Qualifications - Knowledge of North Carolina Medicaid Clinical Policy 3K-1 and 3K-2, and 42 CFR Part 441 Subpart G, 42 CFR § 440.180. - Knowledge of eligibility criteria for LOC and Waiver Participation. - Minimum of two years' experience in a home care setting preferred. - Knowledge of standards of practice related to Medicaid waivers, home and community-based services (HCBS) programs, EPSDT, medical fragility, and level of care determinations. - Knowledge and understanding of public sector services and supports. - Understanding of services provided under the CAP waivers. - Computer proficiency in Microsoft Excel, Word and Outlook. - Ability to utilize computer equipment and web-based software to conduct work. - Ability to interact with various office staff as needed to support necessary workflows. - Ability to interact with healthcare professionals, patients, their families and other supports. - Ability to communicate effectively to individuals and groups through spoken, written and electronic media. - Ability to attend to detail, effectively prioritize and execute tasks in a timely manner. - Ability to work independently without a high degree of supervision. - Develops level of care recommendations based upon clinical evaluations. - Participates in training of CAP stakeholders as needed. - Ability to use person-centered thinking, planning, and have competency in awareness of the needs of persons with disabilities. 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 retirement savings, corporate wellness, educational assistance, corporate discounts, and more. 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 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." Pay Range USD $35.00 - USD $37.08 /Hr.

Conduct needs-based eligibility determinations for Medicaid beneficiaries, perform assessments to recommend levels of care, and engage with stakeholders to ensure compliance with program standards and policies.

Title: Claims, Manager Location: Tallahassee United States Job Description: 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 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. Job Summary and Responsibilities The Claims Manager will lead in managing the billing process for medical services, coordinate with external partners to ensure accurate claims processing, and improve efficiency through data analysis, which will contribute to providing effective healthcare services to our patients. - Managing, directing, monitoring, and providing leadership to direct reports. - Manage activities, workflow, and performance within the department to account objectives, and service levels. - Maintains knowledge of Medicaid and Medicare policies, and procedures pertinent to department or Agency activities. - Identifies processing or administrative policies and procedures needed or recommend changes as required. - Manage Service Level Agreements (SLAs), for a claims processing areas which include, medical bill intake, Authorizations, and Provider Enrollment services. - Maintains close liaison with other departments on matters pertaining to areas of responsibility. - Establish and monitor production goals, communicating results to the team, and identifying and managing underperformance as needed. - Coordinates claim and recovery activities with other departments as necessary. - Responsible for resolution of escalated issues in the day-to-day operations of the department. - Projects and trends future workload volumes and staffing requirements within the department. - Responsible for the selection, training, counseling, and salary administration of direct subordinates. Recognizes and rewards assigned employee. - Responsible for forming developmental plans for employees and performing all reviews. - Review and evaluate all Claims Operations functions routinely, ensuring uniform and documented processes and management strategies are in place. - Develop succession plans for all areas of responsibility. - Must comply with corporate compliance programs and be able to maintain confidentiality. - Must comply with and implement corporate information security policies, standards, and guidelines relative to access control. - Collaborate with the Operations Manager to develop and maintain staff schedules, ensuring contract requirements are met. - Conduct training sessions for team members. - Perform regular team member reviews. - Assist in setting and monitoring production goals, communicating results to the team, and informing the GM of any underperformance. - Process claims as necessary to support production goals. - Review and evaluate all Claims Operations functions, ensuring uniform and documented processes and management strategies are in place - Provide guidance to Claims Team members on day-to-day operations and recommend changes in strategies, plans, and policies - Coordinate all Claims units to ensure the most current versions of the claims system and supporting systems are in use - Oversee claim production, ensuring the company meets both quantity and quality standards - Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. Qualifications Required Qualifications/Experience: Either: - BS/BA degre - Five (5) years in project/program management, enterprise account level management, or other similar customer facing role consulting on or delivering technical products or services related to medical bill processing or similar environment. - Three (3) years of that experience in a project/program management leadership role, consulting on or delivering technical products or services related to medical bill processing or similar environment (may overlap with other experience) - Proven experience running or coordinating projects or programs which include planning work, tracking progress, managing projects, or overseeing accounts in a healthcare-related or billing-related environment. - Proven experience running or coordinating projects or programs which include planning work, tracking progress, managing projects, or overseeing accounts in a healthcare-related or billing-related environment. - Must be willing and able to pass a Federal Background Check OR: - A High School or GED equivalent diploma: - Eight (8) years in project/program management, enterprise account level management, or other similar customer facing role consulting on or delivering technical products or services related to medical bill processing or similar environment. Five (5) years of that experience in a project/program management leadership role, consulting on or delivering technical products or services related to medical bill processing or similar environment (may overlap with other experience) - Proven experience running or coordinating projects or programs which include planning work, tracking progress, managing projects, or overseeing accounts in a healthcare-related or billing-related environment. - Must be willing and able to pass a Federal Background Check This is a hybrid role that requires working onsite at our Tallahassee FL office as needed. Preferred Qualifications/Experience: - A Project Management Professional (PMP) Certification is desired 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. 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 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." Pay Range USD $98,960.00 - USD $108,960.00 /Yr.

Title: RN Clinical Assessor Locations West Virginia, United States; Charleston, West Virginia; Winfield, West Virginia Full-Time Hybrid Employment Type Regular Req ID 5538 Job Description: 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 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. Job Summary and Responsibilities 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. Applicants should reside in Kanawha or Putnam County for best coverage of field work required. 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 Qualifications 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: - Two years of experience in a home care setting - Two years of experience with the 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. 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." 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. #LI-AF1 Pay Range USD $67,300.00 - USD $70,000.00 /Yr.

Conduct clinical assessments of individuals with serious mental illness or intellectual disabilities, recommend appropriate levels of care, and ensure timely completion of evaluations while adhering to program compliance and standards of practice.

Title: RN Clinical Assessor Locations:West Virginia, United States; Charleston, West Virginia; Huntington, West Virginia; Kenova, West Virginia Full-Time Hybrid Regular 5539 Job Description: 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 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. Job Summary and Responsibilities Acentra Health is looking for a RN Clinical Assessor (Personal Care) 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 Personal Care Program and the Aged & Disabled Waiver Program. Personal Care RNs 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 CareConnection and 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. Applicants should reside in Kanawha, Cabell, or Wayne County for best coverage of field work required. 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 PCS eligibility, using state-approved standardized assessment tool(s) - Ensure 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 - Ensure the privacy and dignity of individuals receiving assessment for PCS 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 PCS providers - Submit the completed assessments using state-approved interface - Participate in the Beneficiary's mediation and appeal processes - Attend and actively participate in staff meetings and conduct case consultations/peer reviews/internal auditing as assigned - Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules Qualifications Required qualifications: - Valid, unrestricted Registered Nurse (RN) license for the state of West Virginia or compact license - Associate of Science in Nursing (ASN) degree from an accredited college/university (BSN preferred) - Must have a valid West VA 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: - Two years of experience in a home care setting - Two years of experience with the aging population or with persons with disabilities (preferably working within the WV Personal Care program) - Knowledge of the Personal Care and 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. 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." 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 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. Pay Range USD $67,300.00 - USD $70,000.00 /Yr.