• Registered Nurse - Transition…

    Veterans Affairs, Veterans Health Administration (Richmond, VA)
    …become available for different cohorts up until the closing date. Responsibilities The Registered Nurse Transition to Practice Program is designed for the post ... graduate RN nurse who has completed an entry...opportunities to perform procedures that are performed by RNs. Registered Nurse Transition to Practice (RNTTP) Program… more
    Veterans Affairs, Veterans Health Administration (11/14/24)
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  • Pre-Authorization Registered Nurse

    Humana (Richmond, VA)
    …professional onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN , Intern will utilize Humana's Medicaid training ... the goal to put health first? The Prior Authorization, Registered Nurse , RN , Intern will...experience a plus. + Previous experience in prior authorization, utilization management + Experience working with MCG… more
    Humana (01/15/25)
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  • Registered Nurse , Virtual Care,…

    ChenMed (Richmond, VA)
    …independent judgment **EDUCATION AND EXPERIENCE CRITERIA:** + BSN degree in Nursing required + Registered Nurse ( RN ) licensed to practice nursing in Florida ... we need great people to join our team. The Registered Nurse , CareLine, is responsible for providing...counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call… more
    ChenMed (01/23/25)
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  • Registered Nurse - SCI/D Off-Tour…

    Veterans Affairs, Veterans Health Administration (Richmond, VA)
    Summary This Registered Nurse - SCI/D Off-Tour Clinical Coordinator (Unit 1W) position is located at the Richmond Veterans Affairs Medical Center in Richmond, ... learn more about the position below, along with the duties. Responsibilities The Registered Nurse - SCI/D Off-Tour Clinical Coordinator (Unit 1W) delivers… more
    Veterans Affairs, Veterans Health Administration (01/07/25)
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  • Utilization Management Behavioral…

    Humana (Richmond, VA)
    …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health… more
    Humana (11/13/24)
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  • Utilization Management Nurse

    CVS Health (Richmond, VA)
    …convenient and affordable. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is 100% remote . As a Utilization ... utilize clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program and our plan sponsor(s). You would be… more
    CVS Health (01/24/25)
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  • Care Manager RN - Weekends ( Remote

    Highmark Health (Richmond, VA)
    …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
    Highmark Health (01/07/25)
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  • RN Clinical Consultant, Claims Shared…

    Guardian Life (Richmond, VA)
    …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
    Guardian Life (12/20/24)
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  • Behavioral Health Clinical Liaison, Central Region…

    CVS Health (Richmond, VA)
    …the Central Region.** **Schedule: Monday- Friday 8-5 with occasional holiday weekend utilization management coverage required.** **The BH Clinical Liaison** is a ... clinical leader in the Medicaid plan focusing on utilization management , integrating member care, clinical coordination,...is required: LPC, LCSW, LMFT, BCBA, LBA, or an RN with 5+ years of behavioral health experience +… more
    CVS Health (01/10/25)
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  • Manager Healthcare Services - Virginia

    Molina Healthcare (Richmond, VA)
    **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse or LCSW who lives in VIRGINIA and must be licensed for the state of VIRGINIA. ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
    Molina Healthcare (01/23/25)
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  • Senior Process Improvement Professional

    Humana (Richmond, VA)
    …your skills to make an impact** **Required Qualifications** + Associate degree + Active Registered Nurse , ( RN ), License in your state of residence without ... project management and/or process improvement experience + Minimum 3 years utilization management experience with exposure to grievance and appeals +… more
    Humana (01/23/25)
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