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KEPRO I/DD Waiver Registration Coordinator RN in West Virginia

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 company’s mission, actively engage in problem-solving, and take ownership of your work daily. 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 seeks a I/DD Waiver Registration Coordinator RN to join our growing team.

Job Summary:

The I/DD Waiver Registration Coordinator is key to the authorization of I/DD Waiver services, employing criteria and clinical judgment. This role involves close collaboration with provider agencies, ensuring seamless request processing, and providing excellent customer service, technical assistance, training, and consultation to providers and contractors. The individual classified as RC and RN will have additional task such as reviewing nursing documentation to ensure the requested nursing services meet clinical necessity for the criteria outlined. The RC/RN works closely with provider agencies to obtain needed information in order to process any nursing requests such as nursing notes, dd9's, doctors order, etc.

*Position is remote, but candidates based within the State of West Virginia are preferred.

Job Responsibilities:

  • Evaluate I/DD service authorization requests promptly, aligning decisions with I/DD Waiver policy, member needs, interpretive guidelines, and person-centered planning.

  • Must be able to thoroughly review and assess medical conditions and symptoms and functional abilities in order to provide authorizations for I/DD Waiver consumers that require nursing services.

  • Process dual service requests and I/DD Waiver therapy checks efficiently.

  • Prepare for and attend service denial pre-hearing conferences and hearings to support authorization decisions throughout negotiation and hearings processes in regards to nursing.

  • Prepare and attend exception panel meetings weekly to provide nursing recommendations for I/DD Waiver LPN and RN Services.

  • Provide exceptional customer service and consultation to both providers and contractors, demonstrating outstanding interpersonal, telephone, and negotiation skills to achieve program deliverables.

  • Employ various software tools and web applications to facilitate effective communication and decision-sharing with stakeholders.

  • Maintain confidentiality standards and guarantee compliance with HIPAA regulations when evaluating all pertinent issues.

  • Adhere to ethical standards in decision-making and interactions with members, providers, and contractors.

  • Stay abreast of industry developments, policy changes, and best practices related to I/DD Waiver services.

  • Complete designated responsibilities, including engaging in cross-training with other programs as required.

Requirements

Required Qualifications/Experience:

  • Active unrestricted RN license.

  • Bachelors Degree.

  • A minimum of 2 years’ experience with persons with intellectual and developmental disabilities.

Preferred Qualifications/Experience:

  • Qualified Developmental Disability Professional (formerly QMRP).

  • Proficient understanding of the current I/DD Waiver program policy manual, with a minimum of one year of hands-on experience within the WV I/DD Waiver program.

  • Exemplary verbal and written communication skills.

  • Demonstrated customer service skills, with the ability to multitask, strong organizational aptitude, and flexibility.

  • Proficiency in Microsoft software applications and other relevant tools.

  • Proven ability to teach/train others in person, telephonically, or through web-based/interactive technology.

  • Professional demeanor in all interactions.

  • Strong organizational and time management skills.

  • Ability to work independently, prioritize tasks, manage workload, and meet tight deadlines

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.

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 interest you. Best of luck in your search!

The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE 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, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and 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 $49,700-68,000.

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

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