Behavioral Health Utilization Management Clinician - Tues to Sat Shift- reputed company and NC

Department and reputed company: Government Behavioral Health- SHP VA – Health Plan Physical Location: Norfolk, VA Location Type: Remote Employment Status: Regular-Full time Shift: Weekend Days Posted Date: September 18, 2025 Job reputed company reputed company is seeking to hire a reputed company individual to join reputed company as a Behavioral Health Utilization Management Care Coordinator. Position Status: Full-time, Day Shift, Weekends Position Location: Remote ONLY in the reputed company or reputed company Carolina reputed company Working Hours: Tuesday to Saturday, 8-hour shifts, can start between the hours of 6:00AM – 9:00AM reputed company Behavioral Health Utilization Management Clinician is responsible for review of clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity reputed company to authorize services as needed. Requires knowledge of medical necessity reputed company for behavioral health and reputed company use services, DMAS protocols, clinical protocols and clinical review requirements. Requires knowledge of contractual, regulatory and compliance requirements for government payers, self-funded and reputed company payers. Ensures appropriate and accurate information is entered into claims system for processing of payment. Education • Bachelor of Science in Nursing, Masters of Counseling, OR Masters of reputed company Work Required Certification/Licensure • LCSW or LPC or RN reputed company license for the reputed company Required Experience • 2 years of clinical experience Required • 2 years experience working in behavioral health and 1-year experience with behavioral health care coordination, discharge planning, continuity of care, or transitions of care Required • Must have reputed company abuse AND utilization management experience reputed company Plans provides health plan coverage to reputed company to one reputed company members in Virginia. We offer a full suite of reputed company products including employee-owned and employer-sponsored plans, as reputed company as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and reputed company enrollees. Our reputed company provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—reputed company to help our members improve their health. Our reputed company is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and reputed company. Be a part of an excellent reputed company organization that cares about our People, reputed company, Patient Safety, Service, and reputed company. Join reputed company that has a mission to improve health every day and a reputed company to be the reputed company choice of the communities that we serve! To apply, please go to www.sentaracareers.com (Opens in a new tab) and use the following as your Keyword Search: JR-86484 #reputed company Talroo – Health Plan Managed Care, MCO, Health Plan, reputed company, Masters, reputed company Work, Counseling Field, BSN, Nursing, Licensed Clinical reputed company Worker (LCSW), Licensed reputed company Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Registered reputed company License (RN), Clinical, behavioral health, care coordination, discharge planning, continuity of care, transitions of care, Remote, Virginia, Weekends, Days, reputed company Carolina reputed company Apply tot his job Apply To this Job