- Humana (Richmond, VA)
- …require interpretation and independent determination of the appropriate courses of action. The Post - Acute Utilization Management Nurse 2: + Review ... caring community and help us put health first** The Utilization Management Nurse utilizes clinical nursing skills...1 or more years previous clinical experience in a Post - Acute clinical setting such as a SNF,… more
- Humana (Richmond, VA)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post - acute services (such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Humana (Richmond, VA)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- HCA Healthcare (Richmond, VA)
- …in an acute care setting preferred. + Previous case management or utilization review experience preferred. CJW Medical Center (http://www.cjwmedical.com/) ... act as a liaison between the patient and community resources/ post - acute care providers. The Social Worker SW...payers and maintain legible documentation as directed by the Utilization Management Plan. **What qualifications you will… more
- HCA Healthcare (Richmond, VA)
- …in an acute care setting preferred. + Previous case management or utilization review experience preferred. CJW Medical Center (http://www.cjwmedical.com/) ... act as a liaison between the patient and community resources/ post - acute care providers. The Social Worker SW...payers and maintain legible documentation as directed by the Utilization Management Plan. **What qualifications you will… more
- Bon Secours Mercy Health (Petersburg, VA)
- …Moon, Bundle letters, and Conditions of Participation for DC Planning and Utilization Management , and address opportunities or potential concerns with ... with the physician and care team offering alternatives to acute care, and escalate to care management ...acute care clinical setting (preferred) + Ambulatory or post - acute , care coordination experience (preferred) **Training** EPIC… more
- Humana (Richmond, VA)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Bon Secours Mercy Health (Petersburg, VA)
- …mandated by CMS and Conditions of Participation for discharge planning and utilization management . Addresses opportunities or potential concerns with leadership. ... and assessment of individuals in need of active Case Management services and promotes the right resources, at the...clinical setting (required) 3 years of experience in an acute care clinical setting (preferred) Ambulatory or post… more
- HCA Healthcare (Richmond, VA)
- …and concurrent review for all payers and maintains legible documentation as directed by the Utilization Management Plan + As a member of Case Management team ... + You will refer patients who require extended care post discharge to long-term care facilities. Once an appropriate...Graduate of an accredited school of nursing. + Commercial Utilization Management and/or Case Management … more
- Humana (Richmond, VA)
- …and interpretation skills with 5+ years of experience focusing on quality management , utilization management , discharge planning, rehabilitation services, ... attend Fair Hearings. The clinical scenarios arise from outpatient, post - acute care; acute inpatient; LTC...Clinical Integration, Long Term Services & Supports, and Case Management . The Medical Director, as indicated, could need to… more
- Intermountain Health (Richmond, VA)
- …and program evaluation. + Develops processes, tools, and policies for appropriate utilization management in collaboration with key stakeholders. + Supports ... and maintains positive relationships with medical staff, administration, hospital personnel, post - acute providers, payors, and other community entities. + Leads… more