Sentara Healthcare
Clinical Practice Analyst in Southwest Virginia (Bristol, Roanoke)
5 days agoWhat's your preference?
Job Description
- Req#: JR-93864
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 through Friday
- Opportunity for career advancement and growth within a reputable healthcare organization
- Work remotely 4 days a week, with only 1 day required for in-person meetings in Southwest Virginia
- Comprehensive benefits package including medical, dental, and vision plans, along with generous paid time off
- Annual discretionary bonus eligibility based on established criteria
- Supportive and family-friendly culture that encourages 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 education initiatives
What is Required (Qualifications):
- Must have a Master's Level Degree (MLD)
- Active clinical licensure in the state of Virginia as an LPN, RN, or LCSW
- Minimum of three (3) years of professional experience in a relevant field
- At least one (1) year of experience in quality, regulatory, compliance, accreditation, or auditing
- Knowledge of clinical regulatory requirements, with experience in CMS and state regulatory and accreditation preferred
How to Stand Out (Preferred Qualifications):
- Experience with clinical regulatory requirements and healthcare compliance
- Familiarity with accreditation processes and standards
- Strong analytical skills to assess clinical documentation and provider compliance
- Previous experience in a healthcare organization or managed care setting
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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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