$70K - 90K a year
Review clinical information to ensure medical necessity for authorizing addiction and recovery treatment services and manage claims processing.
Master's degree in Counseling, Social Work, or BSN plus current Virginia clinical licensure and 2 years clinical behavioral health experience with care coordination.
City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health is currently seeking a full-time remote Addiction and Recovery Treatment Services (ARTS) Care Coordinator in Virginia!. Position Status: Full-time, Day Shift Position Location: Remote in the state of Virginia Standard Working Hours: Monday - Friday, 8:00AM - 5:00PM EST. Overview The Addiction and Recovery Treatment Services (ARTS) 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 claims system for processing of payment Education Master's degree in Counseling or Social Work or BSN REQUIRED Certification/Licensure Licensed Clinical Social Worker (LCSW) or Licensed Professional Counselor (LPC) or Licensed Marriage and Family Therapist (LMFT) or Registered Nurse License (RN) current license for the state of Virginia REQUIRED LMHP- S, LMHP-R may be considered if actively working towards licensure and prior experience is present. Experience 2 Years Clinical Experience REQUIRED 2 years experience working in behavioral health and 1 years' experience with behavioral health care coordination, discharge planning, continuity of care or transitions of care REQUIRED Must have at least 1 year experience with substance use Certified Substance Abuse Counselor (CSAC) preferred, but not required. 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-85551 #Indeed Talroo – Health Plan Keywords: Managed Care, MCO, Health Plan, Healthcare, Masters, Social Work, Counseling Field, BSN, Bachelor's, 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, discharge planning, continuity of care, transitions of care, Remote, Virginia, Addiction and Recovery Treatment Services (ARTS), Medicaid, Certified Substance Abuse Counselor (CSAC) 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 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 Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!
This job posting was last updated on 9/2/2025