Inpatient Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN - Remote in VA and NC

Sentara HospitalsNorfolk, Virginia

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Overview

Schedule

Flexible-schedule

Full-time

Education

Nursing (RN, LPN)

Social Work (LSW, LMSW, LICSW)

Career level

Entry-level

Remote

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Job Description

City/State

Norfolk, VA

Work Shift

First (Days)

Overview:

Sentara Health Plans is hiring a Inpatient Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN - Remote in VA and NC!

Status: Full-time, permanent position (40 hours)

Work hours: Flexible dayshift; Can start from 6am to 9am EST, M-F

Location: Fully remote in Virginia OR North Carolina.

Overview

Behavioral Health Utilization Management clinician is responsible for review of clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed.
Requires knowledge of medical necessity criteria for behavioral health and substance use services, DMAS protocols, clinical protocols and clinical review requirements.
Requires knowledge of contractual, regulatory and compliance requirements for government payers, self-funded and commercial payers.
Ensures appropriate and accurate information is entered into claims system for processing of payment.

Education

Master’s degree in Counseling, Social Work, or Marriage and Family Therapy REQUIRED
For Registered Nurses, a Bachelor of Science in nursing is REQUIRED

Certification/Licensure

REQUIRED license must be valid in state of practice. One of the following qualifies:

Licensed Clinical Social Worker (LCSW) - State license- Virginia Department of Health Professionals (VADHP) OR Licensed Clinical Social Worker (LCSW) - State license- North Carolina Social Work Certification and Licensure Board (NCSWCLB) OR

Licensed Professional Counselor (LPC) - State license- Virginia Department of Health Professionals (VADHP) OR Licensed Professional Counselor (LPC) - State license- North Carolina Board of Licensed Clinical Mental Health Counselors (NCBLCMHC) OR

Licensed Marriage and Family Therapist (LMFT) - State license- Virginia Department of Health Professionals (VADHP) OR Licensed Marriage and Family Therapist (LMFT) - State license- North Carolina Marriage and Family Therapy Licensure Board (NCBMFT) OR

Registered Nurse (RN) Single State- Nursing License- Virginia Department of Health Professionals (VADHP) OR Registered Nurse (RN) Single State- Nursing License- North Carolina Board of Nursing (NCBON) OR Registered Nurse (RN) Multi State- Nursing License- Virginia Department of Health Professionals (VADHP) OR Registered Nurse (RN) Multi State- Nursing License- North Carolina Board of Nursing (NCBON) OR
Licensed Substance Abuse Treatment Practitioner (LSATP)
Certified Substance Abuse Counselor (CSAC) OR Licensed Chemical Dependency Counselors (LCDC) preferred

Experience

2 years of behavioral health REQUIRED
1 year of case management REQUIRED
Inpatient Behavioral Health and health plan experience preferred

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search:JR-104143

Talroo – Health Plan

Managed Care, MCO, Health Plan, Healthcare, Masters, Social Work, Counseling Field, BSN, Nursing, Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Registered Nurse License (RN), Clinical, behavioral health, care coordination, discharge planning, continuity of care, transitions of care, Remote, Virginia, Days, North Carolina

Benefits: Caring For Your Family and Your Career

• Medical, Dental, Vision plans

• Adoption, Fertility and Surrogacy Reimbursement up to $10,000

• Paid Time Off and Sick Leave

• Paid Parental & Family Caregiver Leave

• Emergency Backup Care

• Long-Term, Short-Term Disability, and Critical Illness plans

• Life Insurance

• 401k/403B with Employer Match

• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education

• Student Debt Pay Down – $10,000

• Reimbursement for certifications and free access to complete CEUs and professional development

•Pet Insurance •Legal Resources Plan•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work,Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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FAQs About This Job

What is the work location for this position at Sentara Hospitals?

This job at Sentara Hospitals is located in Norfolk, Virginia, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.

What pay range can candidates expect for this role at Sentara Hospitals?

Employer has not shared pay details for this role.

What employment applies to this position at Sentara Hospitals?

Sentara Hospitals lists this position under the following employment categories:

Flexible-schedule
Full-time

What experience level is required for this role at Sentara Hospitals?

Sentara Hospitals is looking for a candidate with "Entry-level" experience level.

Does Sentara Hospitals allow remote work for this role?

Yes, this position at Sentara Hospitals supports remote work, giving candidates the flexibility to work outside the primary office location.

What education level is required for this job?

The education requirement for this position includes Nursing (RN, LPN) and Social Work (LSW, LMSW, LICSW). Candidates with relevant qualifications or equivalent experience may also be considered.

What benefits are offered by Sentara Hospitals for this role?

Sentara Hospitals offers following benefits: Health Insurance, Dental Insurance, Vision Insurance, Disability Insurance, Life Insurance, Family/Dependent Health, Paid Vacation, Paid Sick Leave, Parental and Family Leave, Career Development, 401k Matching/Retirement Savings, and Tuition/Education Assistance for this position. Actual benefits may vary depending on the employer's policies and employment terms.

What is the process to apply for this position at Sentara Hospitals?

You can apply for this role at Sentara Hospitals either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.