Clinical Reviewer (LVN, LPN, or RN)
About The Position
Acentra Health is looking for a Clinical Reviewer (LVN/LPN/RN) to join our growing team. The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements. This is a second shift position with schedule options of either 12:00 PM to 8:30 PM Eastern with every other Saturday, or 10:00 AM to 8:30 PM Eastern with rotating weekend coverage. The department operates seven days a week, so some holiday coverage is required. Major holidays are rotated, schedules are provided in advance, and shift trades may be available.
Requirements
- Active, unrestricted Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN) or Registered Nurse (RN) license from the state where you reside
- Associate's degree or practical/vocational nursing diploma or practical/vocational nursing certificate program, in accordance with state requirements
- 2+ years of experience in long term care, skilled nursing facilities, or acute inpatient care
Nice To Haves
- Knowledge of medical records, medical terminology, and disease processes
- Strong clinical assessment and critical thinking skills
- Excellent written and verbal communication skills
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.
Benefits
- comprehensive health plans
- paid time off
- retirement savings
- corporate wellness
- educational assistance
- corporate discounts
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
