Sentara Healthcare

Clinical Practice Analyst in Tidewater (Norfolk, Virginia Beach, Portsmouth)


PayCompetitive
LocationNew York/New York
Employment typeFull-Time
  • 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 #BenefitsPackage
  • About the company

      Sentara Healthcare is a not-for-profit healthcare organization serving Virginia and northeastern North Carolina.

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