[Hiring] Clinical Reviewer @Acentra Health, LLC

Role Description

Acentra Health is looking for a Clinical Reviewer (LVN/LPN/RN) to join our growing team.

The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements.

Schedule:

• This is a second shift position with schedule options of either 12:00 PM to 8:30 PM Eastern with every other Saturday, or 10:00 AM to 8:30 PM Eastern with rotating weekend coverage.
• The department operates seven days a week, so some holiday coverage is required.
• Major holidays are rotated, schedules are provided in advance, and shift trades may be available.

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 quality monitoring activities.
• Maintains current knowledge base related to review processes and clinical practices.
• Functions as providers' liaison for customer service issues and problem resolution.
• Performs all applicable review types as workload indicates.
• Fosters positive and professional relationships with internal and external customers.
• Attends training and scheduled meetings for current/updated information.
• Cross trains to provide 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 Rules.

Qualifications

• Active, unrestricted Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN) or Registered Nurse (RN) license from the state where you reside.
• Associate's degree or practical/vocational nursing diploma or practical/vocational nursing certificate program, in accordance with state requirements.
• 2+ years of experience in long term care, skilled nursing facilities, or acute inpatient care.

Requirements

• Knowledge of medical records, medical terminology, and disease processes.
• Strong clinical assessment and critical thinking skills.
• Excellent written and verbal communication skills.

Benefits

• Comprehensive health plans.
• Paid time off.
• Retirement savings.
• Corporate wellness.
• Educational assistance.
• Corporate discounts.
• And more.