- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Baylor Scott & White Health (Richmond, VA)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- HCA Healthcare (Richmond, VA)
- …path, we encourage you to apply for our Registered Nurse RN Case Manager opening. We review all applications. Qualified candidates will be contacted ... **Introduction** Do you have the career opportunities as a Registered Nurse RN Case Manager...experience in a hospital setting preferred.** + **Previous case management or utilization review experience… more
- HCA Healthcare (Richmond, VA)
- …every year, nurses at Chippenham Hospital have the opportunity to make a real impact. As a Registered Nurse RN Case Manager you can be a part of change. ... benefits may vary by location._ We are seeking a Registered Nurse RN Case Manager...experience in a hospital setting preferred.** + **Previous case management or utilization review experience… 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)
- …to create an environment where associates want to work and help communities thrive. ** Registered Nurse ( RN ) - Clinical Trial-Oncology - St. Francis - ... Midlothian, VA** **_Are you an RN with Oncology experience? If you have any interest...cardiology step down or critical care experience as a Registered Nurse + Experience within a physician… more
- Elevance Health (Richmond, VA)
- …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… more
- Highmark Health (Richmond, VA)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Sharecare (Richmond, VA)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Highmark Health (Richmond, VA)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- 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
- HCA Healthcare (Richmond, VA)
- …of social work experience in an acute care setting preferred. + Previous case management or utilization review experience preferred. CJW Medical Center ... as appropriate. + You will perform admission and concurrent review for all payers and maintain legible documentation as...payers and maintain legible documentation as directed by the Utilization Management Plan. **What qualifications you will… more
- 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...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… 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)
- …Leadership over staff, supervisors, educator/OR Liaison. Must have solid track record of management and building a successful team. 2. Hires and manages HR issues ... guidelines based on the AAMI Standards. 13. Works closely with surgical services management team on day to day operations and department needs. 14. Manages and… 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
- 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