Clinical Reviewer-Immediate Advocacy (RN/LCSW)-Remote

CNSI and Kepro are now Acentra Health! 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. 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 of passionate individuals dedicated to being a vital partner for health solutions in the public sector.Acentra is looking for a Clinical Reviewer Immediate Advocacy Discharge Assistant to join our growing team. Job Summary:The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with... contract requirements, employing critical thinking and decision-making skills to determine medical appropriateness. This role is crucial for ensuring the accuracy and efficiency of medical record reviews, contributing to enhanced healthcare outcomes and compliance with contractual obligations.JobResponsibilities:Assures accuracy and timeliness of all applicable review type cases within contract requirementsAssesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the departmentIn collaboration with Supervisor, responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areasMaintains 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 concernsFunctions as providers liaison and contact/resource person for provider customer service issues and problem resolution.Performs all applicable review types as workload indicatesFosters 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 processAttends training and scheduled meetings for maintenance and use of current/updated information for reviewCross-trains and performs duties of other contracts to provide a flexible woActive unrestricted LPN or RN clinical licenseBachelor s Degree from an accredited college or university in a related fieldMinimum two years of clinical experience in an acute, med-surgical, post-acute or rehabilitation environment requiredMinimum of one year UR and/or Prior Authorization or related experienceMust be proficient in computer skills including bolthires Office and internet/web navigationPreferred Qualifications/Experience:Knowledge of the organization of medical records, medical terminology, and disease processesStrong clinical assessment and critical thinking skillsMedical record abstracting skillsExcellent written and verbal communication skillsWhy 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 TeamVisit us at Acentra.com/careers/EOE AA M/F/Vet/DisabilityAcentra 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. BenefitsBenefits 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.CompensationThe pay range for this position is $22.56 - $33.00Based 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. Apply tot his job