RN Clinical Reviewer Job at Acentra Health, LLC, Oregon, OH

UkxvbHVrOFlILzhPUmYyZWt5V2NwK1NOTHc9PQ==
  • Acentra Health, LLC
  • Oregon, OH

Job Description

Company Overview:

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.

Job Summary and Responsibilities:

Acentra Health is looking for a RN Clinical Reviewer 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 to determine medical appropriateness.

 

*Candidates must reside within the State of Oregon.

 

**We are currently offering a $3,000 sign on bonus for this position. 


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 quality monitoring activities
  • Maintains current knowledge base related to review processes and clinical practices
  • Functions as providers' liaison for customer service issues and problem resolution
  • Performs all applicable review types as workload indicates
  • Fosters positive and professional relationships with internal and external customers
  • Attends training and scheduled meetings for current/updated information
  • Cross trains to provide flexible workforce to meet client/customer needs
  • Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules
Qualifications:

Required Qualifications

  • Active and unrestricted Registered Nurse (RN) license for Oregon
  • Ability to be licensed for the State of Nebraska, if you don't currently hold a compact license
  • Bachelor's degree from an accredited college or university in a related field
  • 2+ years of experience in Utilization Management or Clinical Review 

Preferred Qualifications

  • Case management experience
  • Knowledge of medical records, medical terminology, and disease processes
  • Strong clinical assessment and critical thinking skills
  • Excellent written and verbal communication skills

Why 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 across the country. We are a company that cares about our employees, and we give 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 be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

EEO AA M/F/Vet/Disability

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.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your 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 listed below. 

“Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”

#LI-AF1

Pay Range: USD $22.69 - USD $43.27 /Hr.

Job Tags

Full time, Contract work, Local area, Relocation bonus, Flexible hours,

Similar Jobs

Hinds Behavioral Health Services

Peer Support Specialist - Mobile Crisis Job at Hinds Behavioral Health Services

 ...with 5% Match, Paid Time Off and much more!Job Summary:The Peer Specialist will perform a wide range of tasks to assist peers of all...  ...Family Time Out. Must successfully pass the Certified Peer Support Specialist after completion of training. Good communication... 

THE ORDINARY

Chef Tournant Job at THE ORDINARY

 ...community and culture that supports sustainability and a local network of purveyors - Professional, polished, dependable, and focused...  ...precise attention to detail - Uphold the highest standards of food safety, food handling and sanitation requirements What you can... 

LJW Solutions

Immigration Attorney Job at LJW Solutions

 ...Business Immigration Attorney - Join a Leading Amlaw 200 Legal Team - Huge Growth Potential Location: Buffalo, NY Are you a driven, motivated, and passionate Associate looking to catapult your career with a progressive and award-winning immigration team?... 

Brixio

Salesforce developer Job at Brixio

Job Location: UAE (on-site) / Philippines (fully remote) or Europe (fully remote) At Brixio, we are committed to providing exceptional service to both our clients and consultant team. With a strong presence in EMEA and APAC, we partner with leading companies across different...

KNET Group

Operations Assistant *BILINGUAL REQUIRED* (Mandarin + English) Job at KNET Group

Role Summary: Were looking for a sharp, proactive, and detail-oriented Operations Assistant to serve as the central communication hub between our warehouses, 3PL partners, and internal teams. This is an on-site position that plays a critical role in keeping day-to-day...