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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:
- Opportunity for career advancement and growth within the organization
- Work remotely 4 days per week with in-person meetings as needed
- Comprehensive benefits package including medical, dental, and vision plans
- Tuition assistance of $5,250/year and student debt pay down of $10,000
- Potential for an annual discretionary bonus based on eligibility criteria
- Supportive and family-friendly culture promoting community involvement
What to Expect (Job Responsibilities):
- Conduct detailed reviews of clinical documentation for accuracy, completeness, and compliance with regulations
- Assess medical necessity, scope, and duration of services against established guidelines
- Identify patterns of outlier activity and escalate concerns for resolution
- Prepare clear, actionable reports and present findings to internal committees or leadership
- Collaborate with providers to implement corrective actions and educational initiatives
What is Required (Qualifications):
- Must have an active clinical licensure in the state of Virginia (LPN, RN, LCSW, or LPC)
- Minimum educational requirement: Master's Level Degree
- A minimum of three (3) years of professional experience in a relevant field
- At least one (1) year of quality, regulatory, compliance, accreditation, and/or auditing experience
- Knowledge of clinical regulatory requirements and experience with CMS and state regulations preferred
How to Stand Out (Preferred Qualifications):
- Experience with clinical regulatory requirements and accreditation processes
- Familiarity with health plan operations and managed care environments
- Strong analytical and problem-solving skills
- Excellent communication and presentation abilities
- Ability to work collaboratively within a multidisciplinary team
#HealthcareServices #ClinicalPractice #RemoteWork #CareerGrowth #EqualOpportunityEmployer
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