Qureos Mentor

Acentra Health

<div>Company Overview:
<div>
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.</div><div></div><div><br>
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 &ndash; 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.</div>
Job Summary and Responsibilities:
<p><b>
Acentra Health is looking for a Clinical Reviewer to join our growing team.</b></p><p><b><br>
Job Summary:</b></p><ul><li>
The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements.</li></ul><p><b><br>
Responsibilities:</b></p><ul><li>
Assures accuracy and timeliness of all applicable review type cases within contract requirements.</li><li>
Assesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department.</li><li>
In collaboration with Supervisor, responsible for quality monitoring activities.</li><li>
Maintains current knowledge base related to review processes and clinical practices.</li><li>
Functions as providers' liaison for customer service issues and problem resolution.</li><li>
Performs all applicable review types as workload indicates.</li><li>
Fosters positive and professional relationships with internal and external customers.</li><li>
Attends training and scheduled meetings for current/updated information.</li><li>
Cross trains to provide flexible workforce to meet client/customer needs.</li><li>
Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.</li></ul><p><i>
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.</i></p>
Qualifications:
<p><b>
Required Qualifications</b></p><br>
<ul><li>
Active unrestricted LPN, RN license required.</li><li>
For LPN - Practical nursing diploma or practical nursing certificate program, in accordance with state requirements.</li><li>
For RN - Associate' or Bachelor's degree from an accredited college or university in a related field.</li><li>
Knowledge of medical records, medical terminology, and disease processes required.</li><li>
Strong clinical assessment and critical thinking skills required.</li><li>
Excellent written and verbal communication skills required.</li></ul><p><b><br>
Preferred Qualifications</b></p><ul><li>
1 year experience with UM</li><li>
Knowledge of InterQual or MCG</li></ul><p></p><p><b><br>
Why us?</b></p><p></p><p><br>
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.</p><p></p><p><b><br>
We do this through our people.</b></p><p></p><p><br>
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.</p><p></p><p><b><br>
Benefits</b></p><p></p><p><br>
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.</p><p></p><p><b><br>
Compensation</b></p><p></p><p><br>
The pay range for this position is listed below.</p><p></p><p><br>
&ldquo;Based on our compensation philosophy, an applicant&rsquo;s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.&rdquo;</p><p></p><p><b><br>
Thank You!</b></p><p></p><p><br>
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!</p><p></p><p><br>
~ The Acentra Health Talent Acquisition Team</p><p></p><p><br>
Visit us at https://careers.acentra.com/jobs</p><p></p><p><b><br>
EEO AA M/F/Vet/Disability</b></p><p></p><p><br>
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.</p>
Pay Range: USD $28.37 - USD $35.00 /Hr.</div>

Clinical Reviewer

<div>Company Overview:
<div>
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.</div><div></div><div><br>
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 &ndash; 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.</div>
Job Summary and Responsibilities:
<p><b>
Acentra Health is looking for a </b><b>RN Chronology</b><b> to join our growing team.</b></p><div><b><br>
Job Summary:</b></div><p></p><p><br>
The RN Chronology role serves as a vital contributor, providing essential analysis and organizational support to key leaders supporting federal health center programs. The RN&rsquo;s clinical expertise, coupled with a keen attention to detail and proficiency in communication and technology, will play a pivotal role in ensuring the seamless drafting of a medical chronology pertinent to the allegations.</p><p></p><p><b><br>
Responsibilities:</b></p><ul><li>
Generate a comprehensive medical chronology report customized for specific claims, ensuring adherence to required/approved formatting and meeting predefined deadlines</li><li>
Prepare thorough medical chronologies based on provided allegations and identify defendants by reviewing claim documents</li><li>
Double-check for accuracy the entries to the claims software system by the administrative assistant</li><li>
Review and organize medical records and legal documents for comprehensive documentation</li><li>
Utilize the claims database to input ICD-10 diagnoses and risk management codes National Practitioner Data Bank (NPDB)</li><li>
Upload or enter completed chronologies into the claims software system</li><li>
Support corporate and contract goals by completing additional tasks as required</li><li>
Collaborate seamlessly with team members on diverse projects, contributing to a dynamic and cooperative work environment</li><li>
Cultivate a constructive and forward-thinking approach, actively engaging in the discovery and recommendation of potential enhancements to internal processes</li><li>
Engage in cross-training responsibilities, carrying out duties on other contract tasks and/or on other contracts as required</li><li>
Support the completion of assigned paid claim chronology reports</li>
Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules<br>
<li>
</li></ul><div><b><i>
** The above list of responsibilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time. **</i></b></div>
Qualifications:
<div><b>
Requirements:</b></div><ul><li>
Active RN license in any U.S. state</li><li>
5+ years of previous clinical experience in an acute care setting required</li><li>
Quality (QI/QA), legal, and/or risk management experience</li></ul><div><b>
Preferred Qualifications:</b></div><ul><li>
Bachelor&rsquo;s degree in nursing preferred</li><li>
Emergency Department and/or Critical Care clinical experience preferred</li><li>
RN with risk management, quality (QI/QA), legal, and/or claims expertise preferred</li><li>
Prior chronology experience preferred</li><li>
Ability to achieve/maintain federal government security clearances</li><li>
Proficient in critical thinking, multitasking, problem-solving, and assessing and interpreting risk</li><li>
Strong analytical, critical thinking, and problem-solving abilities</li><li>
Impeccable organizational skills with meticulous attention to detail</li><li>
Advanced proficiency in Microsoft Office, including Teams, Excel, Word, PowerPoint, OneNote, and SharePoint</li><li>
Technologically adept and comfortable in learning new software programs and functions at a basic level</li><li>
Clear and intentional communication, both verbally and in writing</li><li>
Successful collaboration with personnel at various organizational levels</li><li>
Capacity to manage multiple projects, set priorities, and adapt to changing demands</li></ul><div></div><div><b><br>
Why us?</b></div><div></div><div><br>
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.</div><div></div><div><b><br>
We do this through our people.</b></div><div></div><div><br>
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.</div><div></div><div><b><br>
Benefits</b></div><div></div><div><br>
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.</div><div></div><div><b><br>
Thank You!</b></div><div></div><div><br>
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!</div><div></div><div><br>
~ The Acentra Health Talent Acquisition Team</div><div></div><div><br>
Visit us at https://careers.acentra.com/jobs</div><div></div><div><b><br>
EEO AA M/F/Vet/Disability</b></div><div></div><div><br>
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.</div><div></div><div><b><br>
Experience in Lieu of Degree</b></div><div></div><div><b><br>
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.</b></div><div></div><p><b><br>
Compensation</b></p><p></p><div><br>
The pay for this position is listed below.</div><div></div><div><i><br>
&quot;Based on our compensation philosophy, an applicant&rsquo;s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.&quot;</i></div>
Pay Range: USD $64,960.00 - USD $90,000.00 /Yr.</div>

RN Chronology (Remote U.S.)

Join Acentra Health and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Acentra Health

About Company

Clinical Reviewer

RN Chronology (Remote U.S.)