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

Behavioral Health Utilization Management Care Coordinator (RN / LPC / LCSW / LMFT) – Whole Person Care – Hybrid – Roanoke Region, VA (Sentara Health Plans).

Full‑time, permanent (40 hours per week).
Position location: Hybrid – based in the Roanoke Region (Roanoke, Lexington, Covington, Bedford, Radford, Martinsville and surrounding areas).
Standard working hours: 8 AM to 5 PM EST, Monday–Friday. Responsibilities include traveling approximately two days per week for community visits (home, CSB or hospital) and working three days from home.

Overview: The Behavioral Health Utilization Management Care Coordinator reviews clinical information received from providers to ensure the data meets Medical Necessity Criteria for authorizing services. The role requires knowledge of managed care contracting, Medical Necessity, CMHRS services, BH and ARTS services, DMAS protocols, clinical protocols and review requirements, as well as contractual, regulatory and compliance requirements for government, self‑funded and commercial payers.

The Coordinator ensures accurate information is entered into the claims system for payment processing.

• Education: Master’s degree in Counseling, Social Work, or Marriage and Family Therapy required. For Registered Nurses, a Bachelor of Science in Nursing is required.
• Certification / Licensure: A valid state license in one of the following professions is required:
  • LCSW – State license from Virginia Department of Health Professionals (VADHP) or North Carolina Social Work Certification and Licensure Board (NCSWCLB).
  • LPC – State license from Virginia Department of Health Professionals (VADHP) or North Carolina Board of Licensed Clinical Mental Health Counselors (NCBLCMHC).
  • LMFT – State license from Virginia Department of Health Professionals (VADHP) or North Carolina Marriage and Family Therapy Licensure Board (NCBMFT).
  • RN – Single State Nursing License from Virginia Department of Health Professionals (VADHP) or North Carolina Board of Nursing (NCBON), or Multi‑State Nursing License from the same bodies.
• Experience: 2 years of behavioral health (required); 1 year of case management (required).

• Medical, Dental and 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
• 401(k)/403(b) with Employer Match
• Tuition Assistance – $5,250 per year and discounted educational opportunities through Guild Education
• Student Debt Pay‑Down up to $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Annual discretionary bonus opportunity when eligibility criteria are met

Sentara Health is an equal‑opportunity employer and fosters diversity, inclusion and belonging. This is a tobacco‑free environment.

Sentara Health employs associates in many states, including Virginia, North Carolina and others worldwide. Remote work opportunities may be available for suitable positions.