- Humana (Washington, DC)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse uses behavioral health knowledge and ... licensed in a Compact State** The Utilization Management Behavioral Health Nurse completes...Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse ( RN ) licensure with… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …Mental Health (ICMHR) RN Case Manager is a member of the Behavioral Health Care Service Line whose role is to collaboratively manage, coordinate and provide ... the purpose of improving care to patient groups, maximizing utilization of resources and enhancing the case management...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- HCA Healthcare (Reston, VA)
- …review for all payers and maintains legible documentation as directed by the Utilization Management Plan.** **Educates patients and families to the patient's ... passionate about delivering patient-centered care?** Submit your application for RN Case Management position and spend more...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
- Elevance Health (Arlington, VA)
- …Alexandria, Loudon County or Prince William Counties. The **LTSS Service Coordinator RN Clinician** is responsible for overall management of member's case ... face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral … more
- Highmark Health (Washington, DC)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- Elevance Health (Springfield, VA)
- …contract. **Preferred Skills, Knowledge, and Experience:** + Previous experience with Utilization Management preferred. + Computer experience and experience ... with telephonic assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health,… more
- Somatus (Mclean, VA)
- …Physician's clinical supervision. + Partner with a multidisciplinary team, including RN case managers, social workers, clinical pharmacists, registered ... for diagnostics. + Maintain an up-to-date, evidence-based clinical practice focused on management of CKD and ESKD, delaying kidney disease progression, comorbidity … more