Clinical Reviewer – Remote

If you’re an RN who likes structure, clear criteria, and making clinical calls off the chart, this is a solid remote utilization review-style role. You’ll review medical records against contract criteria to determine medical appropriateness, keep queues moving, and help maintain review quality.

About Acentra Health
Acentra Health provides technology, services, and clinical expertise to support better health outcomes, partnering heavily with public sector programs. Their culture emphasizes ownership, problem-solving, and delivering impact at scale.

Schedule

  • Full-time, remote within the United States
  • Shift: 8:00 a.m. – 4:30 p.m. ET
  • Includes weekend and holiday rotation

What You’ll Do

  • Review medical records against established criteria and contract requirements to determine medical appropriateness
  • Ensure reviews are accurate and completed on time within contract standards
  • Manage daily workload and queues, adjusting work schedules as needed to meet demand
  • Support quality monitoring: identify improvement areas and help implement fixes with your supervisor
  • Serve as an initial resource to other nurse reviewers for review process questions
  • Act as a provider liaison for customer service issues and problem resolution
  • Complete all applicable review types as workload requires
  • Build professional relationships with internal and external stakeholders to support the review process
  • Attend trainings and meetings to stay current on review processes and clinical practice updates
  • Cross-train and assist with other contracts as needed
  • Follow HIPAA privacy/security and all corporate policies

What You Need

  • Active, unrestricted RN license (state/compact as required by contract)
  • Bachelor’s degree from an accredited college or university (related field)
  • Ability to work the stated shift and weekend/holiday rotation

Nice to Have

  • Knowledge of medical records organization, medical terminology, and disease processes
  • Strong clinical assessment and critical thinking skills
  • Medical record abstracting skills
  • Strong written and verbal communication

Pay

  • $28.00 – $32.00 per hour

Benefits

  • Comprehensive health plans
  • Paid time off
  • Retirement savings
  • Corporate wellness
  • Educational assistance
  • Corporate discounts and more

Happy Hunting,
~Two Chicks…

APPLY HERE.