Clinical Reviewer; LCPC or LCSW Remote State

Company Overview

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 Health is looking for a Clinical Reviewer to join our growing team.

Job Summary:

Join Acentra Health as a Clinical Reviewer and make a meaningful impact in the communities we serve. In this vital role, you will leverage your clinical expertise to conduct comprehensive medical record reviews, ensuring alignment with established clinical criteria and contract requirements. Your work will directly support accurate determinations, regulatory compliance, and the delivery of high-quality healthcare outcomes.

As a valued member of our team, you will focus on meeting production targets while consistently upholding the highest quality assurance standards. This full‑time, remote position offers the opportunity to contribute your clinical knowledge in a mission‑driven environment while serving the state of Maine.

• Ensure the accuracy and timeliness of all assigned review cases in accordance with contract requirements and regulatory standards.
• Assess, evaluate and manage daily workloads and review queues to meet the workload demands of the department.
• In collaboration with the Supervisor to support and participate in quality monitoring and continuous improvement initiatives.
• Maintain current knowledge of clinical guidelines, review criteria, regulatory requirements, and industry best practices.
• Serve as a liaison to providers, delivering responsive customer service and facilitating timely issue resolution.
• Perform all applicable review types based on operational needs and workload distribution.
• Cultivate and maintain positive, professional relationships with internal teams and external stakeholders.
• Cross‑train across functions to support a flexible and adaptable workforce that meets evolving client and customer needs.
• Participate in required trainings, team meetings, and professional development activities to remain informed of updates and organizational changes.
• Read, understand, and comply with all corporate policies and procedures, including strict adherence to HIPAA Privacy and Security regulations.

• Active, unrestricted Licensed Clinical Professional Counselor or Licensed Clinical Social Worker required.
• Familiarity with public sector healthcare services and support systems.
• Working knowledge of medical records and medical terminology.
• Strong written and verbal communication skills, with the ability to clearly document, articulate, and explain clinical findings.

• Detail‑oriented with strong organizational skills and the ability to prioritize, manage multiple responsibilities, and meet established deadlines.
• Proficiency in computer systems and web‑based platforms necessary to perform job responsibilities effectively.
• Working knowledge of Microsoft Office Suite, including Word, Excel, Outlook, and Teams.

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.

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…