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 join our team 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 (RN/LCSW)-Remote to join our growing team.

Job Summary:

The Clinical Reviewer is responsible for assessing medical records against established criteria and contract requirements to determine medical appropriateness. The role plays a critical part in ensuring accurate and timely reviews while collaborating with internal and external stakeholders to maintain compliance and improve outcomes

Job Responsibilities:

Ensure the accuracy and timeliness of reviews across all applicable case types per contract standards Assess and manage daily workloads, adjusting schedules to meet departmental demands Conduct quality monitoring activities, identifying areas for improvement and implementing necessary changes Stay current with review processes and clinical practices, acting as the primary resource for nurse reviewers Serve as the provider liaison for customer service inquiries and resolution of issues Perform diverse review types to meet workload demands Build positive relationships with internal and external customers to streamline the review process Attend trainings and meetings to remain updated on review protocols and procedures Support cross-training initiatives to provide flexibility and meet client and customer needs