Clinical Review Specialist

Contact Information

Name:
Elizabeth Weber

Phone:

Email: elizabeth.weberginia.gov

Clinical Review Specialist

Health Care Compliance Spec II

$80,000 (salary commensurate with experience)

5

Dept Behavioral Health/Develop

Western State Hospital

(Use the "Apply for this Job" box below)./

General Public - G

Western State Hospital is Hiring!

Clinical Review Specialist (Registered Nurse II)

This position is primarily day shift but will be required to work off shifts and/or weekends, as needed.

Western State Hospital is seeking an experienced Registered Nurse with strong analytical skills and expertise in reviewing complex clinical documentation to serve as a Clinical Review Specialist.

This is an excellent opportunity for an RN who thrives in a structured, professional setting and enjoys working behind the scenes to support quality care, regulatory compliance, and clinical excellence.

• 13 Paid Holidays
• 12+ Paid Vacation Days
• 9 Paid Sick Days
• 4+ Family Personal Days
• Family Medical Leave
• Short- and Long-Term Disability Coverage
• Low-cost, comprehensive Anthem or Aetna health insurance
• Group and optional life insurance
• Flexible Reimbursement Accounts

• Career ladders and continuing education opportunities
• Internship programs
• Referral bonuses
• Student loan repayment opportunities
• Virginia 529 College Savings Plan (may be available)
• Relocation reimbursement (may be available)
• State employee discounts and more

The Department of Behavioral Health and Developmental Services (DBHDS) supports individuals by promoting recovery, self-determination, and wellness in all aspects of life. DBHDS operates 12 facilities across Virginia, including behavioral health hospitals, a medical center, and rehabilitation services. We are committed to creating a life of possibilities for all Virginians.

Western State Hospital is a 302-bed Joint Commission and CMS-accredited psychiatric hospital located in the beautiful Shenandoah Valley, within 30 minutes of major university towns.

• Is recognized statewide for excellence in Psychosocial Rehabilitation “Learning” Programs
• Has provided consultation to seven other states
• Actively collaborates with community partners
• Is known for strong staff recruitment and retention
• Western State Hospital may be the perfect place to grow your career while contributing meaningfully to behavioral health care.

• Psychiatric/clinical nursing expertise
• Demonstrated knowledge of inpatient psychiatric treatment and documentation requirements to meet State and Federal Medicaid regulations.
• HIPAA and Compliance regulations
• Skilled in analyzing complex clinical documentation to identify discrepancies and recommend improvements, facilitating ongoing quality enhancement efforts
• Ability to communicate effectively, orally and in writing, with clinicians, administrators, patients, patients’ families, and external agencies.
• Basic computer proficiency with typing, and knowledge of MS Word and MS Excel.

• Bachelor's and Masters Degree in Nursing from an accredited institution or higher education
• Psych Nursing experience
• Veteran or Spouse of Veteran
• Bilingual - Spanish

You will be provided a confirmation of receipt when your application and/or résumé is submitted successfully. Please refer to “Your Application” in your account to check the status of your application for this position.

Application Requirements:
Applications and résumés for this position are accepted electronically through the Commonwealth of Virginia’s Electronic Recruitment System only. Interview decisions will be based solely on the information provided in your electronic application and/or résumé. Please ensure you clearly and specifically detail all relevant work experience; we will not make assumptions about your qualifications.

Applications/résumés will begin to be reviewed within five (5) days of the posting date.

All applicants are subject to an extensive background investigation and a pre-employment…