- Humana (Richmond, VA)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Evolent Health (Richmond, VA)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake … more
- CVS Health (Richmond, VA)
- …of care, and appropriate discharge planning + Serve as the behavioral health subject matter expert to support care management staff in serving Aetna ... foster collaboration and provide education and training + Consults with Plan executive management regarding physical and behavioral health clinical issues as… more
- Elevance Health (Richmond, VA)
- …initiatives. **Minimum Requirements:** + Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 ... services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with… more
- HCA Healthcare (Richmond, VA)
- …area of management or leadership. + Preferred - One year previous successful behavioral health nursing management experience, in an acute care setting. ... hours volunteering in our communities. As an RN Manager Behavioral Health with Retreat Doctors' Hospital you...various tasks to staff RN's. Provides cross coverage for Utilization Review. + Maintains a competent staff through working… more
- HCA Healthcare (Richmond, VA)
- …Do you want to join an organization that invests in you as a(an) Behavioral Health Pract PRN? At Chippenham Hospital, you come first. HCA Healthcare ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free...next level of care. + Has working knowledge of utilization management functions and performs these duties… more
- Elevance Health (Richmond, VA)
- …care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational ... Management II** **$2000 Sign on Bonus** At **Federal Health Products and Services - FHPS** , a proud...for multiple managed conditions to ensure cost-effective and efficient utilization of health services. Conducts assessment, planning,… more
- Highmark Health (Richmond, VA)
- …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses ... coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Richmond, VA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- Elevance Health (Richmond, VA)
- …provide an equivalent background. **Preferred Skills, Capabilities and Experiences:** + Case management , discharge planning or behavioral health experience ... program in which members needs are identified, including physical health , behavioral health , social services...**How you will make an impact:** + Manages resource utilization to ensure appropriate delivery of care to members,… more
- Highmark Health (Richmond, VA)
- **Company :** Highmark Health **Job Description :** Job Description **JOB SUMMARY** This role within the marketing & experience department will be at the forefront ... includes leveraging cutting-edge customer experience platforms, implementing robust data management solutions, and optimizing marketing automation tools to drive… more
- Highmark Health (Richmond, VA)
- …**SKILLS** + Driving technology sales + Background on IT + Background in Care Management , Utilization Management , and Digital Products and Services + ... channel growth for enGen. Work closely with marketing, sales engineering and product management to deliver on targets, objectives and provide a voice of the partner.… more
- Bon Secours Mercy Health (Richmond, VA)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... why we're proud to offer our **Bon Secours Mercy Health Nursing Flex Team** , to help our nurses...and skill based on principles of the biological, physical, behavioral , and social sciences + * Application of the… more
- Bon Secours Mercy Health (Midlothian, VA)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body...and skill based on principles of the biological, physical, behavioral , and social sciences + Application of the nursing… more
- Highmark Health (Richmond, VA)
- …resource efficiency. + Proposes ideas, designs, and solutions to lead engineers and management to further cloud service utilization and optimization. + Develops ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...of action. + Level 3 Incident, problem and change management as it pertains to the responsibilities of the… more
- Bon Secours Mercy Health (Midlothian, VA)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body...and skill based on principles of the biological, physical, behavioral , and social sciences + Application of the nursing… more
- Highmark Health (Richmond, VA)
- …in business terms and values. + Manage expectations of customers and management . + Represent various architectural disciplines in customer reviews and planning, ... in their areas of expertise and architecture to peers, developers, management and business users including technical expertise, coaching and ad-hoc training.… more
- Highmark Health (Richmond, VA)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** As Marketing Technology Manager, you will be the technological cornerstone of our marketing & ... utilizing these tools for a range of applications from campaign management to strategic decision-making. **ESSENTIAL RESPONSIBILITIES** + Lead the design,… more
- Bon Secours Mercy Health (Mechanicsville, VA)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... directs patient teaching activities and coordinates the care provided by health team members. **Essential Job Functions** In collaboration with the interdisciplinary… more
- Bon Secours Mercy Health (Mechanicsville, VA)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... directs patient teaching activities and coordinates the care provided by health team members. **Essential Job Functions** In collaboration with the interdisciplinary… more