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Utilization Review Lcsw Jobs in Virginia (NOW HIRING)

Sentara

Licensed Clinical Social Worker

Norfolk, VA

$10K/mo

Overview The Licensed Clinical Social Worker participates as an integral part of a ... Performs patient assessments through the systematic collection and review of patient-specific data ...

Sentara

Licensed Clinical Social Worker

Norfolk, VA

$10K/mo

Overview The Licensed Clinical Social Worker participates as an integral part of a ... Performs patient assessments through the systematic collection and review of patient-specific data ...

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Utilization Review Lcsw information

What are the key skills and qualifications needed to thrive as a Utilization Review LCSW, and why are they important?

To thrive as a Utilization Review LCSW, you need a master's degree in social work (MSW), LCSW licensure, and a strong understanding of clinical assessment and care coordination. Familiarity with medical necessity criteria, insurance guidelines, and electronic health record (EHR) systems is essential, and certification in case management or utilization review is often preferred. Exceptional analytical skills, attention to detail, and clear communication help you advocate effectively for patients and collaborate with healthcare teams. These competencies ensure appropriate care, cost-effectiveness, and compliance with regulatory standards in healthcare delivery.

What are the main challenges Utilization Review LCSWs face when balancing clinical judgment and insurance guidelines?

Utilization Review LCSWs often encounter the challenge of aligning their clinical assessments with insurance coverage criteria, which can sometimes restrict recommended care options. Navigating these situations requires strong communication skills to advocate for appropriate patient care while adhering to payer policies. Frequent collaboration with healthcare providers and insurance representatives is essential to ensure patients receive necessary services without unnecessary delays. This balancing act can be demanding but is also highly rewarding for those who value systemic impact and patient advocacy.

What is a Utilization Review LCSW?

A Utilization Review LCSW (Licensed Clinical Social Worker) is a mental health professional who evaluates the medical necessity, appropriateness, and efficiency of mental health services for patients. They review clinical documentation to ensure that treatments meet insurance and regulatory guidelines, often acting as a liaison between healthcare providers and payers. Their goal is to ensure patients receive necessary care while also reducing unnecessary costs and maintaining compliance with healthcare policies.

What is the difference between Utilization Review Lcsw vs Medical Social Worker?

AspectUtilization Review LcswMedical Social Worker
CredentialsLicensed Clinical Social Worker (LCSW), certification in utilization review often preferredLicensed Clinical Social Worker (LCSW), with clinical social work experience in healthcare
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, clinics, patient homes, healthcare settings
Primary FocusReviewing medical necessity, insurance approvals, and utilization managementProviding psychosocial support, discharge planning, and patient advocacy

The Utilization Review Lcsw primarily focuses on insurance review and utilization management within healthcare settings, requiring knowledge of medical necessity criteria. In contrast, Medical Social Workers provide direct patient support, counseling, and discharge planning. While both roles require an LCSW license, their daily responsibilities and work environments differ significantly.

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What cities in Virginia are hiring for Utilization Review Lcsw jobs? Cities in Virginia with the most Utilization Review Lcsw job openings:
Utilization Review Lcsw jobs near you
Infographic showing various Utilization Review Lcsw job openings in Virginia as of May 2026, with employment types broken down into 1% Internship, 1% As Needed, 25% Full Time, 71% Part Time, and 2% Contract. Highlights an 92% Physical, and 8% Remote job distribution.
Licensed Clinical Social Worker

Licensed Clinical Social Worker

Saratoga Medical Center

Portsmouth, VA • On-site

Full-time, Other

Posted 17 days ago

Job description

Saratoga Medical currently has a number of FULL-TIME openings available for Licensed Clinical Social Worker to work in the SARP clinic or TBI dept at the Portsmouth Naval Medical Center. Employees will work a 40 hour work week schedule, 5 days a week with 8 hour shifts scheduled plus an unpaid lunch break. Shift services will be provided Sunday through Saturday. Day, Evening and Night Shift positions are available and needed. Excellent opportunity to provide residential treatment services to the active duty and dependent population.

Qualifications:

- Possess a Masters Degree in Social Work from an Accredited College/University

- Minimum of 2 years experience working as an LCSW

- Active, unrestricted license to practice as a Clinical Social Worker from any of the 50 U.S. States or U.S. Territories

- BLS certification required prior to start date


Saratoga Medical Center, Inc. is an equal opportunity employer and will not discriminate in recruiting, hiring, training, promotion, transfer, discharge, compensation or any other term or condition of employment on the basis of race, religion, color, age (over age 39), sex, national origin, or on the basis of disability if the employee can perform the essential functions of the job, with a reasonable accommodation if necessary.