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Acentra Health

Modernizes public healthcare with claims solutions

Clinical Evaluator

Mental & Behavioral HealthConfirmed live in the last 24 hours
Part-time

About the Job

Requirements

  • Must possess an active, unrestricted Kansas license as a Licensed Clinical Social Worker, Licensed Master Social Worker, Licensed Marriage and Family Therapist, Licensed Independent Clinical Social Worker, Licensed Clinical Psychologist, Registered Nurse, or another qualified Licensed Mental Health Professional.
  • Must have at least 2 years of experience assessing individuals with mental health or psychiatric disorders, including complex differential diagnoses related to substance use, medical conditions, cognitive impairments, and dementia.
  • Must have at least 2 years of experience assessing and analyzing psychological, emotional, behavioral, and physical functioning, with basic knowledge of standards and best practices for determining level of care within mental health, geriatrics, and conditions commonly requiring long-term care placement.
  • Must comply with corporate policies, including policies related to HIPAA and its Privacy and Security Rules.

Responsibilities

  • Conduct Preadmission Screening and Resident Review assessments and evaluations, and develop informed level-of-care recommendations across nursing homes, hospitals, and community environments.
  • Determine the appropriate next level of care for individuals who may require long-term care placement by assessing each individual's needs.
  • Adhere to state standards of mental health practices, intellectual and developmental disabilities, geriatrics, and other conditions requiring nursing care services and supports.
  • Ensure compliance with contractual and regulatory standards when developing level-of-care recommendations.
  • Use independent judgment, clinical expertise, communication, and problem-solving to navigate complex situations and support outcomes for members, providers, and clients.
  • Collaborate with healthcare professionals, patients, families, and support networks, and monitor personal metrics to meet turnaround-time requirements.
  • Stay informed about current literature, regulations, and research concerning long-term care, mental illness, medical conditions, and geriatrics.
  • Use the state's electronic system and proprietary platforms to manage and track assessment activities.
  • Complete tasks with attention to detail and follow established workflows to maintain quality and operational efficiency.

Desired Qualifications

  • Two years of experience working with individuals with intellectual disabilities and/or other related conditions.
  • One year of experience conducting Preadmission Screening and Resident Review requirements, including applicable federal regulations and state-specific rules.
  • Strong verbal, written, and electronic communication skills for engaging effectively with individuals and groups.
  • Detail-oriented, with organizational skills and the ability to prioritize and complete tasks efficiently within established timelines.
  • Familiarity with public mental health and medical programs.
  • Previous experience working with the geriatric population.
  • Proficiency with computer-based software and tools, including Microsoft Office Suite (Word, Excel, Outlook, and Teams).

About the Company

Acentra Health

Modernizes public healthcare with claims solutions

Acentra Health helps public-sector health programs run better by combining deep knowledge of government health programs with clinical expertise and technology. It designs and delivers software and services for claims, encounter, and provider data to improve processing efficiency and reduce costs, while offering care-management and quality-oversight services that focus on clinically informed decision making. Its products connect providers, payers, and government agencies to streamline workflows and oversight across state and federal programs. The company differentiates itself through its blend of public-sector know-how, clinical focus, and technology, accelerated by the backing of Carlyle, with a goal of delivering measurable outcomes for priority populations. Overall, Acentra Health aims to improve health outcomes, increase program efficiency, and lower costs for government healthcare programs.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
McLean, VA
Founded
2023

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