Sentara Health
VA
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...
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Administration & Operations
Counseling
Nursing
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