Clinical Utilization Case Manager
The James Barry-Robinson Institute / The Barry Robinson Center · barryrobinson.org
NorfolkLead / Manager1+ yrs
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The job in short
Clinical utilization case management.
ExcelAuditClinicalInsurance
Details
- Found
- 9 d ago · posted 2026-10-20
- Location as listed
- NORFOLK, VA, USA
- Role
- Social Worker / Case Manager
- Pay (as listed)
- $55,000–$60,000 a year
- Source
- The company’s own careers site
Full description
Job Details: Job Location: BARRY ROBINSON CENTER - NORFOLK, VA, Position Type: Full Time, Salary Range: $55000.00 - $60000.00Salary/year, The Clinical Utilization Case Manager is the clinical link between our treatment team, the Center, and external payors and case management entities. This role would support the justification of continued residential treatment (RTC) care, ensure clinical documentation is accurate and complete, and maintain case files as required by regulatory agencies and managed care companies.
The ideal candidate is an organized, independent case manager who can translate quality care into clear, payor-ready documentation, and who is committed to supporting military-connected youth and their families.
Qualifications:
Minimum 1 year of clinical experience in an inpatient mental health setting
Ability to manage a caseload of at least 30 clients and meet critical submission deadlines
Strong writing, proofreading, organizational, and time management skills; able to work independently and set priorities
Ability to apply payor criteria to clinical information and write appropriate narrative reports
Quantitative skills to prepare statistical data and reports
Sensitivity to report content and liability issues
Proficiency in Microsoft Office (Outlook, PowerPoint, Excel) and familiarity with EMRs and payor portals
Preferred: Active LPN/RN licensure; BA/BS in a Human Services field; payor experience
This is an on-site position, with working hours from Monday through Friday, 8:30 a.m. to 5:00 p.m.
Responsibilities:
Communicate with payors and case management companies, submitting documentation to justify the authorized level of care by required deadlines
Conduct ongoing utilization review of paper and electronic records to support medical necessity for continued RTC care, and submit updated clinical status reports per payor guidelines
Monitor service delivery for consistency with payor criteria, and report issues that could trigger an audit or jeopardize authorization to your supervisor
Verify that treatment plans and staffing reports are accurate and include all payor-required elements
Review treatment plan problem areas and goals to report client progress to payors
Work with the treatment team monthly (in person or via Zoom, Teams, Outlook) to update reviews and goals and recommend solutions
Collect and assess data for QI monitoring, suggest improvements, and report documentation issues to HIM and the responsible department
Partner with departments and outside providers to ensure documentation is complete and to secure discharge and step-down support
Complete the payor-required discharge summary within the required timeframe for case close-out
In addition to this meaningful work, Barry Robinson Center offers a competitive and comprehensive benefits package, outlined below
Full benefits including medical, dental and vision insurance
403(b) retirement plan with company contribution
Company paid life and long-term disability insurance
Generous Paid Annual Leave (Vacation)
Paid Sick leave
8 Paid Holidays
Tuition reimbursement, details below:
$3,000 per calendar year after 6 months of tenure
$5,000 per calendar year after 2 years of tenure
PLSF Eligible Non-Profit Organization (Public Service Loan Forgiveness Program)
Employee Assistance Program (EAP)
Annual performance reviews
Employee events and activities
Opportunities for advancement
And more!
The Barry Robinson Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Qualifications:
Social Worker / Case Manager jobs in Norfolk, Virginia · Social Worker / Case Manager jobs in the United States · All The James Barry-Robinson Institute / The Barry Robinson Center jobs