- Humana (Richmond, VA)
- …a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills to support ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
- Humana (Richmond, VA)
- …a part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral health knowledge and ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Behavioral Health works within… more
- HCA Healthcare (Richmond, VA)
- **Description** **Introduction** Do you have the career opportunities as a(an) Case Manager Registered Nurse RN PRN you want in your current role? We invest in ... Hospital Forest! **Job Summary and Qualifications** As a Case Manager Registered Nurse (RN), you will provide...payers and maintains legible documentation as directed by the Utilization Management Plan + As a member… more
- Bon Secours Mercy Health (Richmond, VA)
- …mandated by CMS and Conditions of Participation for discharge planning and utilization management . Addresses opportunities or potential concerns with leadership. ... are working or covered by compact (required) Accredited Case Manager Certification (ACM) from American Case Management ...Case Manager Certification (ACM) from American Case Management Association or Certified Case Manager (CCM)… more
- Humana (Richmond, VA)
- …with managers across other departments. + Collaborates with leadership of the Utilization Management , Community Health Workers, HRSN (Social Workers), and ... Humana Healthy Horizons in Virginia is looking for a Manager , Transition Care Management ( Manager ,...sciences, or health related field. + Previous experience in utilization management , discharge planning and/or home health… more
- Molina Healthcare (Richmond, VA)
- …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and...years in one or more of the following areas: utilization management , case management , care… more
- Highmark Health (Richmond, VA)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable...is part of the compact **Preferred** + Certification in Utilization Management or a related field **SKILLS**… more
- Select Medical (Richmond, VA)
- …Illness Recovery Hospital** **(Select Specialty Hospital - Richmond)** **Nurse Manager (RN)** **Shift: Full-Time** **Location: Richmond, VA** At Select ... cost containment for areas of responsibility. + Maintaining effective utilization of manpower, equipment and supplies. + Assessing the...an emphasis on leadership. + 1 year of previous management experience. + Possess a Basic Life Support (BLS)… more
- Elevance Health (Richmond, VA)
- …**Pharmacist Clinical Configuration** is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, ... DIS, and formulary management . **How you will make an impact:** **Primary duties...which would provide an equivalent background. + Requires a registered pharmacist. + Must possess an active unrestricted state… more
- J&J Family of Companies (Richmond, VA)
- …product indications to grow and develop the company's product and technology utilization . The ULS CAS directly partners with a Regional Business Director, Territory ... Managers, EP CAS, Field Service Engineers and Field Management to ensure alignment and coordination of activities to...Create awareness of BWI solutions and facilitates Territory Sales Manager (TM) contact with the key decision makers to… more
- HCA Healthcare (Richmond, VA)
- …a formal pre-admission assessment for acute inpatient rehab through their assigned case manager .** + **Once Case Management has completed the Patient Choice ... 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)
- …+ Ensures the transfer and receipt of all outstanding prior authorization decisions, utilization management data, and clinical information such as prevention and ... transitions are completed. + Works with the Primary Care Manager (PCM) and/or other member-focused departments of the plan...wellness programs(s), care management and complex case management notes. +… more
- HCA Healthcare (Richmond, VA)
- …want your knowledge and expertise! **Job Summary and Qualifications** The Virginia registered pharmacist shall carry out duties assigned by the Director of Pharmacy ... include being directly responsible to the Director of Pharmacy services and Clinical Manager of Pharmacy. The pharmacist is also responsible for the supervision of… 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 ... include being directly responsible to the Director of Pharmacy services and Clinical Manager of Pharmacy. The pharmacist is also responsible for the supervision of… more
- HCA Healthcare (Hopewell, VA)
- …capital equipment requests + You will be responsible for the fiscal management of department; assures proper utilization of organization's financial resources ... or equivalent combination of education and/or experience + Currently licensed as a registered professional nurse in the state in which he or she practices, in… more