Clinical Reviewer Behavioral Health

June 2, 2026

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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. Job Summary and Responsibilities Acentra Health is looking for a Clinical Reviewer of Behavioral Health to join our growing team. Job Summary:The purpose of this position is to review medical records against appropriate criteria in conjunction with contract requirements to determine medical appropriateness. **This position is remote within the United States but will be expected to work during Eastern time zone. Responsibilities:<ul type="disc"><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 the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas</li><li>Maintains current knowledge base related to review processes and clinical practices related to the review processes, functions as the initial resource to nurse reviewers regarding all review process questions and/or concerns</li><li>Functions as providers’ liaison and contact/resource person for provider customer service issues and problem resolution</li><li>Performs all applicable review types as workload indicates</li><li>Fosters 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</li><li>Attends training and scheduled meetings and for maintenance and use of current/updated information for review</li><li>Cross trains and perform duties of other contracts to provide a 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 Rule</li></ul> Qualifications Required qualifications:<div><ul type="disc"><li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Active and unrestricted license for the State of Virginia as a Registered Nurse (RN) OR Licensed Mental Health Professional (LMHP) such as Licensed Clinical Psychologist (LCP), Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), Licensed Substance Abuse Treatment Practitioner (LSATP), Licensed Marriage and Family Therapist (LMFT)</li><li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Associate's degree or higher from an accredited college or university in a related field</li><li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">1+ year of experience in Prior Authorization, Utilization Review, or Utilization Management</li><li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">3+ years of direct experience in a clinical setting or other applicable State clinical experience</li><li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Must be able to work weekends if needed (advance notification will be provided)</li></ul></div>Preferred qualifications:<ul type="disc"><li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Bachelor's degree or higher from an accredited college or university in a related field </li><li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Knowledge of the organization of medical records, medical terminology, and disease process</li><li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Strong clinical assessment and critical thinking skills</li><li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Requires excellent written and verbal communication skills</li><li style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Medical record abstracting skills</li></ul> 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 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. Benefits 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. Experience in Lieu of Degree 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. Compensation The pay range for this position is listed below. “Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.” 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 be of interest. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team <a href="https://acentrahealth-my.sharepoint.com/personal/jayson_miller_acentra_com/Documents/Documents/JD's/Visit%20us at Acentra.com/careers/" target="_blank" rel="noopener">Visit us at https://careers.acentra.com/jobs</a> EEO 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, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. #LI-AF1 Pay Range USD $28.37 - USD $39.19 /Hr.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

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5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

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Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

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Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

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This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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