- Humana (Washington, DC)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse uses behavioral health knowledge and ... licensed in a Compact State** The Utilization Management Behavioral Health Nurse completes...Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse ( RN ) licensure with… more
- HCA Healthcare (Reston, VA)
- …review for all payers and maintains legible documentation as directed by the Utilization Management Plan.** **Educates patients and families to the patient's ... passionate about delivering patient-centered care?** Submit your application for RN Case Management position and spend more...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
- Elevance Health (Arlington, VA)
- …Alexandria, Loudon County or Prince William Counties. The **LTSS Service Coordinator RN Clinician** is responsible for overall management of member's case ... face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral … more
- Highmark Health (Washington, DC)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- Elevance Health (Springfield, VA)
- …contract. **Preferred Skills, Knowledge, and Experience:** + Previous experience with Utilization Management preferred. + Computer experience and experience ... with telephonic assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health,… more
- Somatus (Mclean, VA)
- …Physician's clinical supervision. + Partner with a multidisciplinary team, including RN case managers, social workers, clinical pharmacists, registered ... for diagnostics. + Maintain an up-to-date, evidence-based clinical practice focused on management of CKD and ESKD, delaying kidney disease progression, comorbidity … more