Clinical Reviewer of Behavioral 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 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 Clinical Reviewer of Behavioral Health 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, critical thinking, and decision- making skills to determine medical appropriateness. 

*This position is remote within the United States; however, candidates must be licensed in the state of Virginia or hold a compact license.

Job 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 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 the initial resource to nurse reviewers regarding all review process questions and/or concerns
• Functions as providers’ liaison and contact/resource person for provider customer service issues and problem resolution
• Performs all applicable review types as workload indicates
• Fosters positive and professional relationships and act 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 and for maintenance and use of current/updated information for review
• Cross trains and perform duties of other contracts to provide a flexible workforce to meet client/customer needs

Requirements

Required Qualifications/Experience: 

• Active unrestricted Licensed Practical Nurse (LPN), Registered Nurse (RN), or Licensed Mental Health Professional (LMHP) the same as defined in Physician, Licensed Clinical Psychologist, Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), Licensed Substance Abuse Treatment Practitioner, Licensed Marriage and Family Therapist (LMFT), Certified Psychiatric Clinical Nurse Specialist, License Behavior Analyst, Licensed Psychiatric/Mental Health Nurse Practitioner
• Bachelor’s Degree from an accredited college or university in a related field
• 3+ years of experience in Utilization Management

Preferred Qualifications/Experience: 

• Knowledge of the organization of medical records, medical terminology, and disease process
• Strong clinical assessment and critical thinking skills
• Requires excellent written and verbal communication skills
• Medical record abstracting skills

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 $22.56-40.87 per hour. 

“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.”