- Bon Secours Mercy Health (Newport News, VA)
- …**This is a PRN position at Mary Immaculate Hospital** **Licensing/ Certification** + Acute Registered Nurse ( RN ) (required) + BLS Basic Life Support - ... rules and regulations and Conditions of Participation for DC Planning and Utilization Review , and address opportunities or potential concerns with leadership.… more
- Select Medical (Newport News, VA)
- …Illness Recovery Hospital** **Director of Case Management** **_Clinical license as a registered nurse or respiratory therapist or master's in social work ... and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan… more
- Fresenius Medical Center (Portsmouth, VA)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Elevance Health (Norfolk, VA)
- …Health 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 range of experience with… more
- Elevance Health (Norfolk, VA)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... the Possibilities. Make an Extraordinary Impact.** The **Medical Management Nurse ** is responsible for the review of...an equivalent background. + Current active, valid and unrestricted RN license and/or certification to practice as a health… more
- Molina Healthcare (Hampton, 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. ... identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- …duties as assigned. + LICENSES AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact ... + GENERAL SUMMARY + The Revenue Integrity Nurse Auditor is responsible for the auditing and...required. + Three to five years of case management utilization review , or compliance related work experience… more
- Elevance Health (Norfolk, VA)
- …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... **Medical Management Nurse ** **Federal Employee Program - FEP** , a...an equivalent background. + Current active, valid, and unrestricted RN license and/or certification to practice as a health… more
- Bon Secours Mercy Health (Norfolk, VA)
- …and operational excellence. **Summary of Primary Function** In the capacity of a Registered Nurse , the Ambulatory Care Manager will provide clinical care ... Bachelor's Degree Specialty/Major Nursing (BSN) **Licensing/ Certification** Licensure/Certification **Required** Registered Nurse with active License in State… more
- Veterans Affairs, Veterans Health Administration (Virginia Beach, VA)
- …care team (LPN, RN , Clinician/Provider, Social worker, Pharmacist, etc.). to review the clinic utilization by using various report clinic utilization ... coordinated care delivery model. Coordinates with the patient care team to review clinic [appointment availability ( utilization ) to ensure that clinic schedules… more
- Veterans Affairs, Veterans Health Administration (Chesapeake, VA)
- …care team (LPN, RN , Clinician/Provider, Social worker, Pharmacist, etc.). to review the clinic utilization by using various report clinic utilization ... statistical summary, Encounter Action Required Report (EARR), clinic cancellations, specialty consults report, Consult Tracking Manager (CTM), recall delinquency report, secure messages, VeTEXT, VAR, as well as SAIL/ HEDIS metrics that directly impact the… more