United States onlyCNSI and Kepro are now Acentra Health! 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 company’s mission, actively engage in problem-solving, and take ownership of your work daily. 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 seeks a Clinical Reviewer – LCPC/LCSW (Remote in Maine) to join our growing team.
Job Summary:
The purpose of this position is to complete level-of-care assessments for community-based behavioral health services. Position will also review needs-based eligibility determinations for youth who are applying for Medicaid-behavioral health services provided in their home or in certified residential care facilities.
- Conducts clinical assessments with guardians and treatment team members via Microsoft teams and/or zoom setting.
- Utilizes clinical expertise to review medical records against appropriate MaineCare criteria.
- Provides a comprehensive assessment in conjunction with contract requirements, critical thinking, and clinical decision-making skills to determine medical appropriateness while maintaining professionalism and QA standards.
** This is a remote-based position where you can work from home. However, per contract requirements you must reside in Maine and have an active LCPC and/or LCSW. **
Job Responsibilities:
- Reviews and interprets patient records and compares against criteria to determine medical necessity and appropriateness of care; determines whether the medical record documentation supports the need for services.
- Determines approval or initiates a referral to the physician consultant.
- Abstracts review related data/information accurately and timely on the appropriate review tool as determined by DHHS.
- Accurate and timely submission of all administrative and review-related documents to appropriate parties.
- Performs ongoing reassessment of the review process to offer opportunities for improvement and/or change.
- Foster positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the review process.
- Responsible for attending training and scheduled meetings.
- Always maintains medical records confidentiality through proper computer password use, maintenance of secured files, and adherence to HIPAA policies.
- Utilizes proper telephone etiquette and judicious use of other verbal and written communications, following Acentra Health policies, procedures, and guidelines
- Actively cross-trains to perform duties of other contracts within the Acentra Health network to provide a flexible workforce to meet client/consumer needs.
The above list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
Requirements
Required Qualifications/Experience:
- Active LCPC and/or LCSW.
- Graduate from an accredited Master's Degree Program.
- 1+ years of assessment experience.
- 3+ years of direct behavioral/mental health experience in a clinical setting.
- Medical record abstracting skills.
- Knowledge of the organization of medical records and medical terminology.
- Strong clinical assessment and critical thinking skills.
- Excellent verbal and written communication skills.
- Ability to work in a team environment.
- Flexibility and strong organizational skills.
- Must be proficient in Microsoft Office and Internet/web navigation.
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 nationwide. Our company cares about our employees, giving 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 interest you. Best of luck in your search!
~ The Acentra Health Talent Acquisition Team
Visit us at Acentra.com/careers/
EOE 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 additional protection, security, and support for your career and 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 $73,000-75,000 annually.
“Based on our compensation philosophy, an applicant’s placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”
