Behavioral Health Utilization Management Care Coordinator - Remote VA

Sentara
life insurance, paid time off, sick time, tuition assistance, 401(k), 403(b), remote work
United States, Virginia, Norfolk
Apr 25, 2025
City/State Norfolk, VA Work Shift Weekend Days Overview: Sentara Health is seeking to hire a qualified individual to join our team as Behavioral Health Utilization Management Care Coordinator. Position Status: Full-time, Day Shift, Weekends Position Location: Remote ONLY in the state of Virginia Standard Working Hours: Friday, Saturday, Sunday, and Monday, 10-hour shifts, can work between the hours of 6:00AM - 6:00PM Overview Behavioral Health Utilization Management Care Coordinator applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health outpatient and/or inpatient services, Mental Health Services (MHS), and/or Addiction Recovery and Treatment Services (ARTS). Responsible for reviewing clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed. Utilizes clinical experience and skills in a collaborative process to assess appropriateness of treatment plans across levels of care, applying evidence-based standards, and practice guidelines to treatment where appropriate. Requires knowledge of managed care contracting, medical necessity, and Medicaid and Medicare behavioral health and substance use services. Knowledge of DMAS protocols, NCQA, CMS, clinical protocols and clinical review requirements. Education Bachelor of Science in Nursing, Masters of Counseling, OR Masters of Social Work Required Certification/Licensure LCSW or LPC or LMFT or RN current license for the state of Virginia Experience 2 years of experience working in behavioral health Required 1 year of experience with behavioral health care coordination, discharge planning, continuity of care or transitions of care Required Benefits: Caring For Your Family and Your Career * 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 ifestablished system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer* and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle 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, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.