LSATP for Substance Abuse - Remote in VA and NC

Sentara Health•Virginia Remote, VA

8d•Remote

About The Position

Sentara Health Plans is hiring a Behavioral Health Utilization Management Clinician for Substance Abuse. This is a full-time, permanent position requiring 40 hours per week with flexible dayshift hours, starting between 6am and 9am EST, Monday through Friday. The role is fully remote and open to candidates located in Virginia or North Carolina. The Behavioral Health Utilization Management Clinician is responsible for reviewing clinical information from providers to ensure it meets Medical Necessity Criteria for authorizing services. This role requires knowledge of medical necessity criteria for behavioral health and substance use services, DMAS protocols, clinical protocols, and clinical review requirements. Additionally, knowledge of contractual, regulatory, and compliance requirements for government, self-funded, and commercial payers is necessary. The clinician will also ensure appropriate and accurate information is entered into the claims system for payment processing.

Requirements

Master’s degree in Counseling, Social Work, or Marriage and Family Therapy REQUIRED
For Registered Nurses, a Bachelor of Science in nursing is REQUIRED
REQUIRED license must be valid in state of practice. One of the following qualifies: Licensed Clinical Social Worker (LCSW) - State license - Virginia Department of Health Professionals (VADHP) OR Licensed Clinical Social Worker (LCSW) - State license - North Carolina Social Work Certification and Licensure Board (NCSWCLB) OR Licensed Professional Counselor (LPC) - State license - Virginia Department of Health Professionals (VADHP) OR Licensed Professional Counselor (LPC) - State license - North Carolina Board 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 - North Carolina Marriage and Family Therapy Licensure Board (NCBMFT) OR Registered Nurse (RN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP) OR Registered Nurse (RN) Single State - Nursing License - North Carolina Board of Nursing (NCBON) OR Registered Nurse (RN) Multi State - Nursing License - Virginia Department of Health Professionals (VADHP) OR Registered Nurse (RN) Multi State - Nursing License - North Carolina Board of Nursing (NCBON) OR Licensed Substance Abuse Treatment Practitioner (LSATP)
2 years of behavioral health REQUIRED
1 year of case management REQUIRED

Nice To Haves

Certified Substance Abuse Counselor (CSAC) OR Licensed Chemical Dependency Counselors (LCDC) preferred
Experience in substance abuse in American Society of Addiction Medicine (ASAM) levels of care) and utilization management preferred

Responsibilities

Review of clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed.
Ensures appropriate and accurate information is entered into claims system for processing of payment.

Benefits

Medical, Dental, Vision plans
Adoption, Fertility and Surrogacy Reimbursement up to $10,000
Paid Time Off and Sick Leave
Paid 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 Guild Education
Student Debt Pay Down – $10,000
Reimbursement for certifications and free access to complete CEUs and professional development
Pet Insurance
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.