Sentara
Clinical Practice Analyst- Virginia Beach, VA
6 days agoWhat's your preference?
Job Description
- Req#: JR-91725
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Full-time, permanent position with a standard schedule of 8 AM to 5 PM EST, Monday to Friday
- Opportunity for career advancement and growth within a reputable healthcare organization
- Work remotely four days a week, with one day required to visit providers in Virginia Beach, VA
- Comprehensive benefits package including medical, dental, vision, and 401k/403B with employer match
- Annual discretionary bonus opportunity based on eligibility criteria
- Supportive work culture that encourages community involvement and professional development
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):
- Bachelor's or Master's Level Degree in Social Work is required
- Active clinical licensure in the state of Virginia as an LPN, RN, or appropriate social work/counselor licensure (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 and experience with CMS and state regulations preferred
How to Stand Out (Preferred Qualifications):
- Experience with clinical regulatory requirements and auditing processes
- Familiarity with CMS and state regulatory and accreditation requirements
- Additional certifications related to healthcare compliance or quality assurance
#HealthcareServices #ClinicalPractice #RemoteWork #CareerGrowth #HealthcareComplianceAbout the company
Join a national healthcare leader dedicated to growth, innovation and patient safety. Join Sentara.
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