• RN , Utilization Review Flexi

    Chesapeake Regional Healthcare (Chesapeake, VA)
    Summary The Utilization Review Nurse combines clinical expertise with knowledge of medical appropriateness criteria, and applies principles of utilization ... resources as a facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of… more
    Chesapeake Regional Healthcare (02/16/25)
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  • Acute Care Nurse , HCT ( RN )

    ChenMed (Newport News, VA)
    RN with bachelor's degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... we need great people to join our team. The Nurse Case Manager 1 ( RN ) is responsible...patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with… more
    ChenMed (03/05/25)
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  • Acute Care Nurse , HCT ( RN )

    ChenMed (Norfolk, VA)
    RN with bachelor's degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... of communication. + Introduce self to patient/family and explain nurse case manager role and process to contact ...is preferred. + Minimum of two (2) years of utilization review , case management, home health and/or… more
    ChenMed (03/05/25)
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  • Registered Nurse - Case Manager…

    Bon Secours Mercy Health (Newport News, VA)
    …**This is a PRN position at Mary Immaculate Hospital** **Licensing/ Certification** + Acute Registered Nurse ( RN ) (required) + BLS Basic Life Support - ... rules and regulations and Conditions of Participation for DC Planning and Utilization Review , and address opportunities or potential concerns with leadership.… more
    Bon Secours Mercy Health (01/13/25)
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  • Dialysis Clinical Manager, Registered

    Fresenius Medical Center (Norfolk, VA)
    …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
    Fresenius Medical Center (03/06/25)
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  • Behavioral Health Care Manager II - UM Behavior…

    Elevance Health (Norfolk, VA)
    …Health PulsePoint office. This utilization management role is responsible for utilization management review for Behavior Analysis services. **How you will ... equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA (as allowed by...is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with… more
    Elevance Health (02/04/25)
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  • Manager, Healthcare Services - Behavioral Health

    Molina Healthcare (Chesapeake, 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. ... identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational… more
    Molina Healthcare (02/09/25)
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  • Revenue Integrity Nurse Auditor

    Childrens Hospital of The King's Daughters (Chesapeake, VA)
    …duties as assigned. + LICENSES AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact ... + GENERAL SUMMARY + The Revenue Integrity Nurse Auditor is responsible for the auditing and...required. + Three to five years of case management utilization review , or compliance related work experience… more
    Childrens Hospital of The King's Daughters (01/25/25)
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  • Med Mgmt Nurse (US)

    Elevance Health (Norfolk, VA)
    …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... **Medical Management Nurse ** **Federal Employee Program - FEP** , a...an equivalent background. + Current active, valid, and unrestricted RN license and/or certification to practice as a health… more
    Elevance Health (03/05/25)
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  • Advance Medical Support Assistant Specialty…

    Veterans Affairs, Veterans Health Administration (Chesapeake, VA)
    …care team (LPN, RN , Clinician/Provider, Social worker, Pharmacist, etc.). to review the clinic utilization by using various report clinic utilization ... coordinated care delivery model. Coordinates with the patient care team to review clinic [appointment availability ( utilization ) to ensure that clinic schedules… more
    Veterans Affairs, Veterans Health Administration (03/05/25)
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  • Practical Nurse - Ambulatory Care

    Veterans Affairs, Veterans Health Administration (Hampton, VA)
    …patient information. Completed work should need only a general review by a registered nurse ( RN ) or physician (MD/DO) for appropriateness and conformity ... Richmond VHA Salem VHA Salisbury Responsibilities The Licensed Practical Nurse (LPN) reports to the designated Nurse ...safe use and operation of equipment. Seeks guidance from RN and/or provider regarding resolution of clinical issues. May… more
    Veterans Affairs, Veterans Health Administration (03/12/25)
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  • Medical Quality Coordinator

    Chesapeake Regional Healthcare (Chesapeake, VA)
    …credentialing Certificates, Licenses, Registrations Applicant must be licensed to work as a Registered Nurse in the Commonwealth of Virginia, and must obtain ... The Medical Quality Coordinator coordinates an effective medical staff peer review process that supports medical staff reappointment, advancement, and clinical… more
    Chesapeake Regional Healthcare (02/04/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Norfolk, VA)
    **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Ideal candidates will reside within 50 miles of an Elevance Health Pulse Point ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for performing care management within the… more
    Elevance Health (03/13/25)
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  • Telephonic Nurse Case Mgr II

    Elevance Health (Norfolk, VA)
    **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the… more
    Elevance Health (03/11/25)
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