Inpatient Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN - Remote in VA and NC
Sentara Health Administration, Inc. —Norfolk, VA
- Full-time
- Remote
- LMFT
- Nursing
- Addiction Medicine
- 403(b) matching
- Paid parental leave
Quick Apply
13d
Utilization Review Specialist (Flexi)
Chesapeake Regional Medical Center —Chesapeake, VA
- Part-time
- Nursing
- Mid-level
- Case management
Quick Apply
Trauma Clinical Reviewer (Trauma Registrar)
Childrens Hospital of The Kings Daughters —Norfolk, VA
- $43.63 an hour
- Part-time
- Nursing
- RN License
- Customer service
Nurse Case Manager
Battelle —Norfolk, VA
- Full-time
- Hybrid work
- Nursing
- RN License
- BLS Certification
- Wellness program
- Health insurance
Travel RN - Case Management/Utilization Review - Case Management
American Traveler —Chesapeake, VA
- $2,486 a week
- Weekends as needed
- Acute care
- RN License
- BLS Certification
Quick Apply

Related jobs to explore

Based on your search for utilization review nurse

Inpatient Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN - Remote in VA and NC
Sentara Health Administration, Inc. —Norfolk, VA
REQUIRED license must be valid in state of practice. Licensed Clinical Social Worker (LCSW) - State license - Virginia Department of Health Professionals (VADHP…
Quick Apply
13d
Trauma Clinical Reviewer (Trauma Registrar)
Childrens Hospital of The Kings Daughters —Norfolk, VA
Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact State license required. Bachelor’s degree in Nursing required.
$43.63 an hour

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Case Manager (RN) - Full-Time
OhioHealth Rehabilitation Hospital —Columbus, OH
Current Licensure per state guidelines in clinical or related discipline OR a Bachelor's or Master's in a health or human services discipline.
$70,000 - $84,000 a year
Quick Apply
1d
Case Manager / PRN ( RN / RT / SW / LPN )
Select Specialty Hospital - Columbus Vic Village(Grant) —Columbus, OH
Current licensure in a clinical discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR current license / certified Social Work license per…
Quick Apply

Show more jobs in cities nearby

I want to receive the latest job alert for utilization review nurse in virginia beach va

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization review nurse jobs near virginia beach va

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

Sentara Health Administration, Inc.
Norfolk, VA

Quick Apply

Job Details

Full-time
13 days ago

Benefits

403(b) matching
Paid parental leave
Caregiver leave
Disability insurance
Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Parental leave
Employee assistance program
Vision insurance
401(k) matching
403(b)
Life insurance
Pet insurance

Qualifications

Regulatory compliance
Clinical case management
Working with individuals with mental health conditions
Legal compliance

Full 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.

Quick Apply

Refine Your Search

utilization review nurse jobs in virginia beach va

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

Utilization Review Specialist (Flexi)

Trauma Clinical Reviewer (Trauma Registrar)

Nurse Case Manager

Travel RN - Case Management/Utilization Review - Case Management

Related jobs to explore

Explore jobs in cities nearby

I want to receive the latest job alert for utilization review nurse in virginia beach va

Explore jobs in more locations

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

Job Seeker Tools

Employer Tools

Browse

Stay Connected