Behavioral Health Utilization Management Care Coordinator/RN/LPC/LCSW/LMFT- Whole Person Care- Hybri

City/StateRoanoke, VAWork ShiftFirst (Days)Overview:Sentara Health Plans is hiring for a Behavioral Health Utilization Management Care Coordinator- Whole Person Care- Hybrid in the Roanoke RegionPosition Status: Full-time, permanent (40 hours/week)Position Location: This is a hybrid role based in Roanoke Region (Roanoke, Lexington, Covington, Bedford, Radford, Martinsville, and the surrounding areas). The role includes travel of up approximately 2 days per week in the community (home, CSB, or hospital visits as needed) and 3 days working from home.Standard Working Hours: 8 AM to 5 PM EST, M-FOverviewBehavioral Health Utilization Management Care Coordinator is responsible for review of clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed. Requires knowledge of managed care contracting, Medical Necessity, CMHRS services, BH and ARTS services, DMAS protocols, clinical protocols and clinical review requirements. Requires knowledge of contractual, regulatory and compliance requirements for government payers, self-funded and commercial payers. Ensures appropriate and accurate information is entered into the claims system for processing of payment.EducationMaster's degree in Counseling, Social Work, or Marriage and Family Therapy required. For Registered Nurses, a Bachelor of Science in nursing is required.Certification/LicensureRequired 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)ORLicensed Clinical Social Worker (LCSW) - State license - North Carolina Social Work Certification and Licensure Board (NCSWCLB)ORLicensed Professional Counselor (LPC) - State license - Virginia Department of Health Professionals (VADHP)ORLicensed Professional Counselor (LPC) - State license - North Carolina Board of Licensed Clinical Mental Health Counselors (NCBLCMHC)ORLicensed Marriage and Family Therapist (LMFT) - State license - Virginia Department of Health Professionals (VADHP)ORLicensed Marriage and Family Therapist (LMFT) - State license - North Carolina Marriage and Family Therapy Licensure Board (NCBMFT)ORRegistered Nurse (RN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP)ORRegistered Nurse (RN) Single State - Nursing License - North Carolina Board of Nursing (NCBON)ORRegistered Nurse (RN) Multi State - Nursing License - Virginia Department of Health Professionals (VADHP)ORRegistered Nurse (RN) Multi State - Nursing License - North Carolina Board of Nursing (NCBON)Experience2 years of behavioral health (Required)1 year of case management (Required)Sentara Health Plansprovides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.Our quality 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-all to help our members improve their health.Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serveTo apply, please go towww.sentaracareers.comand use the following as your Keyword Search:JR-91559#IndeedTalroo - Health PlanManaged Care, MCO, Health Plan, Healthcare, Masters, Social Work, Counseling Field, BSN, Nursing, Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Registered Nurse License (RN), Clinical, behavioral health, care coordination, case management, Hybrid, Roanoke, Lexington, Covington, Radford, Martinsville, BedfordBenefits: Caring For Your Family and Your CareerMedical, 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 developmentPet InsuranceLegal Resources PlanColleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.Sentara Health is an equal opportunity employerand 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.