[Hiring] Clinical Reviewer-RN @Acentra Health, LLC

Role Description

Acentra Health is looking for a Clinical Reviewer-RN to join our growing team. The purpose of this position is to review medical records against appropriate criteria in conjunction with contract requirements to determine medical appropriateness.

• 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 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.
• Performs all applicable review types as workload indicates.
• Fosters positive and professional relationships and acts 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 for maintenance and use of current/updated information for review.
• Cross trains and performs duties of other contracts to provide a flexible workforce to meet client/customer needs.
• 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

• A minimum of 2 years of clinical experience.
• An active unrestricted RN in the South Carolina and/or Compact State clinical license per contract requirements.
• Bachelor’s Degree is preferred.
• Knowledge of the organization of medical records, medical terminology, and disease process required.
• Strong clinical assessment and critical thinking skills required.
• Medical record abstracting skills required.
• Requires excellent written and verbal communication skills.

Benefits

• 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.”

Pay Range: USD $28.37 - USD $39.19 /Hr.