Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN for reputed company Abuse - Flexible Weekend Dayshift - Remote in VA and NC

reputed company/State Norfolk, VA Work Shift Weekend Days reputed company: reputed company Plans is hiring a Behavioral Health Utilization Management Clinician/LCSW/LPC/LMFT/RN for reputed company Abuse - Flexible Weekend Dayshift - Remote in VA and NC! Status: Full-time, permanent position (40 hours) Work hours: Flexible weekend dayshift; Can start from 6am to 9am EST for a 4 x 10 hour shift (Thursday to reputed company) Location: Fully remote in Virginia OR Northeast reputed company Carolina. 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  Master’s degree in Counseling, reputed company Work, or Marriage and Family Therapy REQUIRED For Registered Nurses, a Bachelor of Science in nursing is REQUIRED Certification/Licensure  REQUIRED license must be reputed company in state of reputed company. One of the following qualifies:  Licensed Clinical reputed company Worker (LCSW) - State license - Virginia Department of Health Professionals (VADHP) OR Licensed Clinical reputed company Worker (LCSW) - State license - reputed company Carolina reputed company Work Certification and Licensure reputed company (NCSWCLB) OR  Licensed reputed company Counselor (LPC) - State license - Virginia Department of Health Professionals (VADHP) OR Licensed reputed company Counselor (LPC) - State license - reputed company Carolina reputed company of Licensed Clinical Mental Health Counselors (NCBLCMHC) OR  Licensed Marriage and Family Therapist (LMFT) - State license - Virginia Department of Health Professionals (VADHP) OR Licensed Marriage and Family Therapist (LMFT) - State license - reputed company Carolina Marriage and Family Therapy Licensure reputed company (NCBMFT) OR  Registered reputed company (RN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP) OR Registered reputed company (RN) Single State - Nursing License - reputed company Carolina reputed company of Nursing (NCBON) OR Registered reputed company (RN) Multi State - Nursing License - Virginia Department of Health Professionals (VADHP) OR Registered reputed company (RN) Multi State - Nursing License - reputed company Carolina reputed company of Nursing (NCBON)  Licensed reputed company Abuse Treatment Practitioner (LSATP) OR Certified reputed company Abuse Counselor (CSAC) OR Licensed Chemical Dependency Counselors (LCDC) preferred Experience  2 years of behavioral health REQUIRED 1 year of case management REQUIRED  Experience in reputed company abuse in reputed company) reputed company of care) and utilization management preferred 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 and use the following as your Keyword Search: JR-99154 #LI-PM1 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, Licensed reputed company Abuse Treatment Practitioner, LSATP, Certified reputed company Abuse Counselor, CSAC, Licensed Chemical Dependency Counselors, LCDC, reputed company) Benefits: Caring For Your Family and Your Career • Medical, Dental, reputed company plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • reputed company Time Off and reputed company Leave • reputed company Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through reputed company Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free reputed company to complete CEUs and reputed company development •Pet Insurance  •reputed company Resources Plan •Colleagues have reputed company to earn an annual discretionary bonus if established system and employee eligibility reputed company is met. reputed company is an equal opportunity employer and prides itself on the diversity and inclusiveness of its reputed company to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding reputed company of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, reputed company employs associates in the following states: Alabama, Delaware, Florida, reputed company, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, reputed company Carolina, reputed company Dakota, Ohio, Oklahoma, reputed company, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, reputed company Virginia, reputed company, and Wyoming. Apply To This Job