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

Join the Acentra Health Team: Empowering Better Health Outcomes Acentra Health is a pioneering healthcare company that leverages technology, services, and clinical expertise to innovate health solutions that deliver maximum value and impact. Our mission is to empower better health outcomes, and we're looking for passionate individuals like you to join our team. As a Clinical Reviewer - Immediate Advocacy Discharge Assistant, you will play a crucial role in ensuring the accuracy and efficiency of medical record reviews, contributing to enhanced healthcare outcomes and compliance with contractual obligations. About Acentra Health We're 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. Our company cares about our employees, giving you the tools and encouragement you need to achieve the finest work of your career. Job Summary The Clinical Reviewer - Immediate Advocacy Discharge Assistant is responsible for utilizing 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. Key Responsibilities Accurate and Timely Review of Medical Records: Assures accuracy and timeliness of all applicable review type cases within contract requirements. Workload Management: Assesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department. Quality Monitoring: In collaboration with Supervisor, responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas. Clinical Expertise: 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. Provider Liaison: Functions as providers' liaison and contact/resource person for provider customer service issues and problem resolution. Review Types: Performs all applicable review types as workload indicates. Relationship Building: 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. Training and Meetings: Attends training and scheduled meetings for maintenance and use of current/updated information for review. Cross-Training: Cross-trains and performs duties of other contracts to provide a flexible workforce. Requirements Essential Qualifications: Active Unrestricted LPN or RN Clinical License Bachelor's Degree: Bachelor's Degree from an accredited college or university in a related field. Clinical Experience: Minimum two years of clinical experience in an acute, med-surgical, post-acute or rehabilitation environment required. UR and/or Prior Authorization Experience: Minimum of one year UR and/or Prior Authorization or related experience. Computer Skills: Must be proficient in computer skills including Microsoft Office and internet/web navigation. Preferred Qualifications/Experience: Knowledge of Medical Records: Knowledge of the organization of medical records, medical terminology, and disease processes. Clinical Assessment and Critical Thinking: Strong clinical assessment and critical thinking skills. Medical Record Abstracting: Medical record abstracting skills. Communication Skills: Excellent written and verbal communication skills. Career Growth Opportunities and Learning Benefits At Acentra Health, we offer unparalleled opportunities for career growth and development. You'll have access to: Comprehensive Training: Ongoing training and education to enhance your skills and knowledge. Mentorship: Opportunities to work with experienced professionals who can guide and support your career. Career Advancement: Opportunities for career advancement and professional growth. Work Environment and Company Culture We offer a dynamic and supportive work environment that values: Collaboration: We believe in the power of teamwork and collaboration. Innovation: We're committed to innovation and continuous improvement. Diversity and Inclusion: We value diversity and inclusion, and strive to create a workplace that's welcoming and inclusive for all. Compensation, Perks, and Benefits We offer a comprehensive compensation package that includes: Competitive Salary: The pay range for this position is $22.56 - $33.00. Comprehensive Benefits: Comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Why Join Acentra Health? By joining Acentra Health, you'll have the opportunity to: Make a Meaningful Impact: Contribute to better health outcomes and make a positive impact on people's lives. Grow Your Career: Access opportunities for career growth and development. Work with a Dynamic Team: Collaborate with a team of experienced and caring professionals. How to Apply Ready to join us? The first step is easy. Click Apply Now and we'll be in touch soon! Equal Opportunity Employer: Acentra 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. Apply for this job