[Hiring] Part-time Clinical Reviewer - Substance Use (LPCC, LMFT, LICSW) @Acentra Health, LLC

Role Description

Acentra Health is looking for a Part time Clinical Reviewer - Substance Use (LPCC, LMFT, LICSW) 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.

• The role is part time and remote within the United States but requires an active Minnesota license or ability to obtain one within 6 months of accepting an offer.
• It follows standard business hours, with an expected schedule of 20 to 30 hours per week, and a preference for candidates located in the Central Time Zone.

Responsibilities:

• Review and interpret patient records against American Society of Addiction Medicine (ASAM) criteria to determine medical necessity and appropriateness of care.
• Responsible for attending training and scheduled meetings and for maintenance and use of current/updated information for review.
• 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 providers’ liaison and contact/resource person for provider customer service issues and problem resolution.
• 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.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Qualifications

• The selected candidate must hold an active, unrestricted license in the state of Minnesota in one of the following areas:
  • LPCC, issued by the Minnesota Board of Behavioral Health and Therapy (BBHT) or compact license
  • LMFT, issued by the Minnesota Board of Marriage and Family Therapy (BMFT)
  • LICSW, issued by the Minnesota Board of Social Work (BOSW)
• If the selected candidate does not currently hold an active, unrestricted LPCC, LMFT, or LICSW license in Minnesota, they must be eligible for and able to obtain the required licensure within six months of accepting an offer.
• 3+ years of experience providing direct clinical work as a mental health professional across diverse clinical settings
• 1+ years of Utilization Review (UR) OR Utilization Management (UM) OR Prior Authorization
• In-depth understanding of ASAM criteria and its practical application in clinical environments
• Familiarity with medical records structure, terminology, and disease processes
• Strong clinical assessment capabilities paired with excellent critical thinking
• Proficient in medical record abstraction
• Regardless of work schedule, all new hires must attend a Monday orientation. If Monday is a Company‑observed holiday, orientation will be held on Tuesday instead

Requirements

• Proficiency in Microsoft Office 365 applications, including Word, Excel, Outlook and Teams.
• Excellent written and verbal communication skills.
• Demonstrated ability to manage deadlines, prioritize tasks, and thrive in a fast-paced environment.
• Highly organized with meticulous attention to detail.

Benefits

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

Company 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.

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.