Sentara
Clinical Practice Analyst in Northwest Virginia (Charlottesville, Harrisonburg, Lexington)
5 days agoWhat's your preference?
Job Description
- Req#: JR-93865
Employer Industry: Healthcare Managed Care
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely four days per week, with one day for in-person meetings
- Comprehensive benefits package including medical, dental, vision, and tuition assistance
- Annual discretionary bonus eligibility based on established criteria
- Supportive and family-friendly work culture that encourages community involvement
- Programs available for professional development and certification reimbursement
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 education initiatives
What is Required (Qualifications):
- Minimum educational requirement: Master's Level Degree
- Active clinical licensure in the state of Virginia (LPN, RN, LCSW, or LPC)
- Minimum of three (3) years of professional experience in a relevant field
- At least one (1) year of experience in quality, regulatory, compliance, accreditation, and/or auditing
- Knowledge of clinical regulatory requirements, with experience in CMS and state regulations preferred
How to Stand Out (Preferred Qualifications):
- Experience with clinical regulatory requirements
- Familiarity with state regulatory and accreditation requirements
- Prior experience in a healthcare setting focused on compliance and quality assurance
#HealthcareManagedCare #ClinicalAnalyst #RemoteWork #CareerGrowth #ProfessionalDevelopmentAbout the company
Join a national healthcare leader dedicated to growth, innovation and patient safety. Join Sentara.
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.