Sentara
Clinical Practice Analyst in Central Virginia (Richmond, Chesterfield, Petersburg)
5 days agoWhat's your preference?
Job Description
- Req#: JR-93863
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Full-time, permanent position with standard working hours from 8 AM to 5 PM EST, Monday through Friday
- Opportunity for career advancement and growth within the organization
- Work remotely 4 days per week with one day required in the field visiting providers
- Comprehensive benefits package including medical, dental, vision plans, and up to $10,000 for adoption, fertility, and surrogacy reimbursement
- Annual discretionary bonus opportunity based on eligibility criteria
- Supportive and family-friendly culture that encourages community involvement
What to Expect (Job Responsibilities):
- Conduct detailed reviews of clinical documentation for accuracy and compliance with regulations
- Assess medical necessity and scope of services against established guidelines
- Identify patterns of outlier activity and escalate concerns for resolution
- Prepare and present clear, actionable reports to internal committees or leadership
- Collaborate with providers to implement corrective actions and education initiatives
What is Required (Qualifications):
- Master's Level Degree (MLD) is required
- Active clinical licensure in the state of Virginia as an LPN, RN, or LCSW
- Minimum of three (3) years of professional experience required, including at least one (1) year in quality, regulatory, compliance, or auditing
- Knowledge of clinical regulatory requirements preferred, including experience with CMS and state regulations
- Virginia state requirements for licensure must be met and maintained
How to Stand Out (Preferred Qualifications):
- Experience with health plan or managed care environments
- Familiarity with accreditation processes and standards
- Strong analytical skills and attention to detail
- Excellent communication and interpersonal skills
- Ability to work collaboratively in a team-oriented environment
#HealthcareServices #ClinicalPractice #RemoteWork #CareerOpportunity #Compliance
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Join a national healthcare leader dedicated to growth, innovation and patient safety. Join Sentara.
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