City/State
Norfolk, VAWork Shift
Multiple shifts availableOverview:
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 www.sentaracareers.com 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, Quality, Regulatory, Compliance, Accreditation, Auditing
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established 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.
Sentara Healthcare Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Sentara Healthcare and has not been reviewed or approved by Sentara Healthcare.
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Parental & Family Support — Four weeks of paid parental leave at full base pay and two weeks of job‑protected family caregiver leave support major life and care needs. Emergency back‑up care and reimbursements for infertility, adoption, and surrogacy further bolster family support.
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Retirement Support — A 401(A) plan alongside 403(B)/401(K) employer matching is designed to strengthen long‑term financial security. Company‑paid life insurance with buy‑up options adds additional protection for families.
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Flexible Benefits — Choice of medical plan designs and dental/vision options enables tailoring coverage to individual needs. An annual election between tuition assistance and student‑loan repayment offers flexibility to align with financial or education priorities.
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What We Do
Sentara Healthcare celebrates a 130-year history of innovation, compassion and community benefit. Based in Norfolk, VA, Sentara is a diverse not-for-profit family of 12 hospitals, an array of integrated services and a team of nearly 30,000 strong on a mission to improve health every day. This mandate is pursued through a disciplined strategy to achieve Top 10% performance in key measures through shared best practices, transformation of primary care through clinical integration and strategic growth that adds value to the communities we serve in Virginia and North Carolina.
