Sentara Healthcare
Clinical Practice Analyst in Northwest Virginia (Charlottesville, Harrisonburg, Lexington)
5 days agoWhat's your preference?
Job Description
- Req#: JR-93865
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Full-time, permanent position with standard working hours of 8 am to 5 pm EST, Monday to Friday
- Opportunity for career advancement and growth within the organization
- Remote work flexibility for 4 days a week, with only 1 day required on-site
- Comprehensive benefits package including medical, dental, and vision plans, as well as tuition assistance and student debt pay down
- Potential for an annual discretionary bonus based on eligibility criteria
- Supportive and family-friendly workplace culture
What to Expect (Job Responsibilities):
- Conduct detailed reviews of clinical documentation to ensure accuracy and compliance with regulatory standards
- Assess medical necessity and appropriateness of services against established guidelines
- Identify and escalate patterns of outlier activity for resolution
- Prepare and present clear, actionable reports to internal committees or leadership
- Collaborate with providers to implement corrective actions and educational initiatives
What is Required (Qualifications):
- Master's Level Degree (MLD) required
- Active clinical licensure in the state of Virginia (LPN, RN, LCSW, or LPC)
- Minimum of three (3) years of professional experience required
- At least one (1) year of experience in quality, regulatory, compliance, accreditation, and/or auditing
- Knowledge of clinical regulatory requirements and experience with CMS and state regulatory and accreditation requirements preferred
How to Stand Out (Preferred Qualifications):
- Experience in a healthcare setting with a focus on managed care or health plans
- Familiarity with clinical documentation standards and compliance protocols
- Strong analytical skills and ability to present data effectively
- Previous experience working collaboratively with healthcare providers
- Additional certifications related to quality assurance or clinical compliance
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"We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer."About the company
Sentara Healthcare is a not-for-profit healthcare organization serving Virginia and northeastern North Carolina.
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