Sentara Healthcare
Clinical Practice Analyst in Tidewater (Norfolk, Virginia Beach, Portsmouth)
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Job Description
- Req#: JR-91725
Employer Industry: Healthcare Insurance
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely four days a week with one day for in-person meetings in Virginia Beach, VA
- Comprehensive benefits package including medical, dental, and vision plans
- Tuition assistance of $5,250 per year and student debt pay down of up to $10,000
- Annual discretionary bonus eligibility based on performance
- Supportive and family-friendly culture promoting 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 and escalate patterns of outlier activity for resolution
- Prepare actionable reports and present findings to internal committees or leadership
- Collaborate with providers to implement corrective actions and education initiatives
What is Required (Qualifications):
- Bachelor's or Master's Level Degree in Social Work 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 preferred
How to Stand Out (Preferred Qualifications):
- Experience with clinical regulatory requirements, particularly CMS and state accreditation
- Familiarity with quality improvement initiatives in healthcare settings
- Previous roles in healthcare compliance or auditing environments
#HealthcareInsurance #ClinicalPractice #RemoteWork #CareerGrowth #BenefitsPackageAbout the company
Sentara Healthcare is a not-for-profit healthcare organization serving Virginia and northeastern North Carolina.
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