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 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 – 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 is looking for a Clinical Reviewer - Behavioral Health - PRN (Remote within Arkansas)

** The selected candidate must be available for at least the first 90 days between 8:00 AM – 5:00 PM Central, Monday through Friday, but the availability can vary. **

** This is a fully remote position where you must reside and work in the state of Arkansas. **

** There is no required Travel for this role. **

Job Summary:

Completes prior authorization, continued stay, and retroactive and retrospective quality reviews for Inpatient and Outpatient Behavioral Health Providers. Collaborates with the Clinical Director and Team Supervisor, monitors provider trends, reviews government-funded behavioral health program utilization activities, and makes internal policy, procedure, and process recommendations. Collaborates with Team Supervisor and Medical Director to determine Medical Necessity of services. Serves as a resource for Behavioral Health providers. Assists Provider Relations Specialist with program-specific education and training. Maintains client’s privacy, confidentiality, and safety always. Adherence to ethical, legal, and accreditation/regulatory standards.

Job Responsibilities:

Completes initial and concurrent prior authorization and retrospective reviews for Behavioral Health services. Performs reviews assessing the quality and compliance of services documentation in the client record, ensuring documentation complies with relevant Arkansas Medicaid regulations and referring services to the Physician Reviewer for medical necessity determination if warranted. Acts as a liaison for Behavioral Health Providers regarding the review process. Educates Behavioral Health Providers on the Reconsideration and Appeal process.