- CVS Health (Richmond, VA)
- …utilization of available resources and optimal, cost-effective outcomes. + Telephonic clinical case management with Medicare population. + Uses Motivational ... 3+ years of direct clinical practice experience + An active and unrestricted clinical behavioral health license in state of residence is required (ex: LPC,… more
- Molina Healthcare (Richmond, VA)
- **JOB DESCRIPTION** For this position we are seeking a Case Manager who lives in VIRGINIA and must be licensed for the state of VIRGINIA. Case Manager ... setting supporting our SMI (Severe Mental Illness) Medicaid Population. Case Manager will be required to physically...per regulated timelines and determines who may qualify for case management based on clinical judgment, changes… more
- Molina Healthcare (Midlothian, VA)
- …a RN who lives in VIRGINIA and must be licensed for the state of VIRGINIA. Case Manager RN will work in remote and field setting supporting our SMI (Severe ... Mental Illness) Medicaid Population. Case Manager will be required to physically...per regulated timelines and determines who may qualify for case management based on clinical judgment, changes… more
- Humana (Richmond, VA)
- …us put health first** Humana Healthy Horizons in Kentucky is seeking a Field Care Manager , Behavioral Health 2 who will assess and evaluate member's needs and ... the care and wellbeing of members. The Field Care Manager , Behavioral Health 2 work assignments are...license with a minimum of 1 year of post-degree clinical experience in behavioral health **OR** an… more
- Elevance Health (Richmond, VA)
- …you will make an impact:** + Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary ... quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as… more
- Highmark Health (Richmond, VA)
- …+ 3 - 5 years of post licensure experience in a combination of Behavioral Health Clinical , Case Management and/or Condition Management + Experience ... resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors… more
- Molina Healthcare (Richmond, VA)
- **JOB DESCRIPTION** Case Manager RN will work in remote and field setting supporting our Medicaid Population (Including Maternity and Pediatric Population. ... health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If… more
- HCA Healthcare (Richmond, VA)
- **Description** **Introduction** Do you have the career opportunities as a(an) Social Worker Case Manager you want with your current employer? We have an ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...Do you want to work as a Social Worker Case Manager where your passion for creating… more
- Molina Healthcare (Richmond, VA)
- …Nurse who lives in VIRGINIA and must be licensed for the state of VIRGINIA. Case Manager will work in remote and field setting supporting our Medicaid Population ... with. Case Manager will be required to physically...an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high… more
- HCA Healthcare (Richmond, VA)
- …where diversity and inclusion thrive? Submit your application for our Social Worker SW Case Manager opening with Chippenham Hospital today and find out what it ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...by location._ We are seeking a Social Worker SW Case Manager for our team to ensure… more
- Highmark Health (Richmond, VA)
- …Nursing **EXPERIENCE** **Required** + 7 years of any combination of clinical , case management and/or disease/condition management experience, provider operations ... panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs of...interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are… more
- HCA Healthcare (Richmond, VA)
- …**Introduction** Do you have the PRN career opportunities as a **Social Worker SW Case Manager PRN** you want with your current employer? We have an ... for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and...by location._** We are seeking a Social Worker SW Case Manager PRN for our team to… 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 ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...Doctors' Hospital Forest! **Job Summary and Qualifications** As a Case Manager Registered Nurse (RN), you will… more
- CVS Health (Richmond, VA)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** Case Manager Analyst is responsible for face to face and ... telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to… more
- Highmark Health (Richmond, VA)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- Elevance Health (Richmond, VA)
- …office visits with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering ... will be responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and...manager . + May be responsible for an entire clinical program and/or independently performs clinical reviews.… more
- Elevance Health (Richmond, VA)
- …Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee ... impact:** + Determines the medical necessity of requests using clinical criteria. + Performs physician-level case review...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Richmond, VA)
- …and providers. **How you will make an impact:** + Ensures timely completion of clinical case reviews for their board-certified specialty. + Makes physician to ... Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee… more
- HCA Healthcare (Richmond, VA)
- …care. Performs in accordance with physician's orders and under the supervision of the Clinical Manager . **What you will do in this role:** + Assesses home ... and patient/family/caregiver. + Communicates significant findings, problems and changes to Clinical Manager and physician, and documents all findings,… more
- HCA Healthcare (Richmond, VA)
- …care. Performs in accordance with physician's orders and under the supervision of the Clinical Manager . **What you will do in this role:** + Assesses home ... and patient/family/caregiver. + Communicates significant findings, problems and changes to Clinical Manager and physician, and documents all findings,… more