Clinical Reviewer-PRN (RN)

Qualifications

Required Qualifications/Experience

• Active, unrestricted Registered Nurse (RN) License in any state, or an RN compact state License. A minimum of 2+ years of clinical experience in an acute OR med-surgical environment. Knowledge of medical records, medical terminology, and disease process organization. Skilled in reviewing, interpreting, and abstracting data from medical records. Strong clinical assessment and critical thinking skills. Excellent verbal and written communication skills. Must be proficient in Microsoft Office and internet/web navigation.
• Preferred
• Qualifications/Experience: Bachelor's Degree from an accredited college or university in a related field. Knowledge of current National Committee for Quality Assurance (NCQA) standards. Knowledge of Utilization Review Accreditation Commission (URAC) standards. Knowledge of Independent Review Organization (IRO). Knowledge of Medicare (CMS) guidelines. Experience with Medical Appeals. Ability to work in a team environment. Flexibility and strong organizational 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.

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. This position includes access to select Acentra Health benefits and programs, such as participation in the Acentra Health 401(k) Plan with company match, access to wellness and employee discount programs, and Employee Assistance Program (EAP) resources. 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 Visit us at http://careers.acentra.com/jobs 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, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Experience in Lieu of Degree For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree. 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.”

Pay Range

Usd $28.37 - Usd $39.19 /Hr.