City/State Norfolk, VA
Work Shift Multiple shifts available
Overview: Sentara Health Plansis hiring a Clinical Compliance Consultant/LPN/RN/LCSW/LPC - Remote in Virginia! Status: Full-time,permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F Location: This position is remote and applicants must be located in Virginia. Overview Reporting to the Program Manager, the Clinical Compliance Consultant will be responsible for supporting the clinical and regulatory compliance of designated lines of business through project leadership, technical oversight, and risk identification and mitigation. The Consultant will create policies, procedures, and tools that will help implement recommendations in addition to development metrics to be utilized for monitoring program objectives and policies and procedures that support compliance with regulatory and accreditation standards.
Education - Master's degree (Preferred)
Certification/Licensure - One of the following is required :
- Licensed Clinical Social Worker (LCSW) - State license - North Carolina Social Work Certification and Licensure Board (NCSWCLB)
- Licensed Clinical Social Worker (LCSW) - State license - Virginia Department of Health Professionals (VADHP)
- Licensed Practical Nurse (LPN) Multi State - Nursing License - North Carolina Board of Nursing (NCBON)
- Licensed Practical Nurse (LPN) Multi State - Nursing License - Virginia Department of Health Professionals (VADHP)
- Licensed Practical Nurse (LPN) Single State - Nursing License - North Carolina Board of Nursing (NCBON)
- Licensed Practical Nurse (LPN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP)
- Licensed Professional Counselor (LPC) - State license - North Carolina Board of Licensed Clinical Mental Health Counselors (NCBLCMHC)
- Licensed Professional Counselor (LPC) - State license - Virginia Department of Health Professionals (VADHP)
- Registered Nurse (RN) Multi State - Nursing License - North Carolina Board of Nursing (NCBON)
- Registered Nurse (RN) Multi State - Nursing License - Virginia Department of Health Professionals (VADHP)
- Registered Nurse (RN) Single State - Nursing License - North Carolina Board of Nursing (NCBON)
- Registered Nurse (RN) Single State - Nursing License - Virginia Department of Health Professionals (VADHP)
Experience - 1 year of quality, regulatory, compliance, accreditation, and/or auditing experience (Required)
- Behavioral Health and Case Management experience highly preferred
- Health plan experience preferred
Sentara Health Plans provides 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 serve! To apply, please go to and use the following as your Keyword Search: JR-99651 Talroo-Health Plan
Clinical Compliance Consultant, LPN, RN, LCSW, LPC, Behavioral Health, Nursing, Nurse, Counseling, Social Work, Managed Care, MCO, Health Plan, Healthcare, Q uality, Regulatory, Compliance, Accreditation, Auditing
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.
