- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- HCA Healthcare (Richmond, VA)
- …your career path, we encourage you to apply for our Case Manager Registered Nurse RN PRN opening. We review all applications. Qualified candidates will ... you have the career opportunities as a(an) Case Manager Registered Nurse RN PRN you...payers and maintains legible documentation as directed by the Utilization Management Plan + As a member… more
- Bon Secours Mercy Health (Midlothian, VA)
- …stewardship to create an environment where associates want to work and help communities thrive. ** Registered Nurse ( RN ) - Clinical Nurse Educator - ... delivery **EMPLOYMENT QUALIFICATIONS:** Must be currently licensed as a Registered Nurse in the State of Virginia...Basic Life Support - American Heart Association + Valid RN Nursing License from the state of practice +… more
- Humana (Richmond, VA)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in the state of Virginia or ... licensure + Previous Medicare/Medicaid experience a plus + Previous experience in utilization management , case management , discharge planning and/or home… more
- Humana (Richmond, VA)
- …and help us put health first** The Compliance Nurse 2 reviews case management and utilization management activities and documentation to ensure adherence ... Quality leadership. **Use your skills to make an impact** **Required Qualifications** + Active Registered Nurse license in the state of Virginia, or obtain a… more
- 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. ... integrated) performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical… more
- Humana (Richmond, VA)
- …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… more
- Sedgwick (Richmond, VA)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **We are growing and looking for nurses who have their ... clinical data; to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers for Medicare &… more
- HCA Healthcare (Richmond, VA)
- …+ **Performs other duties as assigned.** **Requirements:** + **Bachelors Degree** + ** Registered Nurse , or Occupational Therapy (OT), or Licensed Physical ... through clinical screenings and assessments in collaboration with both hospital Case Management and the Rehab Medical Director and works closely with hospital case… more
- Humana (Richmond, VA)
- …EPSDT Coordinator must** **meet** **on** **e** **of** **the** **following:** + Virginia-licensed registered nurse OR + physician's assistant OR + Bachelor's ... preventative care and assist with appointment and transportation scheduling as necessary * Review EPSDT services and assessments and HEDIS data to identify gaps in… more
- ChenMed (Colonial Heights, VA)
- …and explain nurse practitioner role. Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... and explain nurse practitioner role. Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education… more
- Elevance Health (Richmond, VA)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- HCA Healthcare (Richmond, VA)
- …we do. We want you to apply! **Job Summary and Qualifications** The Virginia registered pharmacist shall carry out duties assigned by the Director of Pharmacy and ... organizing, networking, completing and improving the work activities through effective management of time, tasks and available personnel. + Maintains knowledge… more