- Humana (Richmond, VA)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Humana (Richmond, VA)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post - acute services (such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- ChenMed (Colonial Heights, VA)
- …role. Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post -SNF needs. ... role. Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post -SNF needs.… more
- HCA Healthcare (Richmond, VA)
- …in an acute care setting preferred. + Previous case management or utilization review experience preferred. CJW Medical Center (http://www.cjwmedical.com/) ... act as a liaison between the patient and community resources/ post - acute care providers. The Social Worker SW...payers and maintain legible documentation as directed by the Utilization Management Plan. **What qualifications you will… more
- Humana (Richmond, VA)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Bon Secours Mercy Health (Richmond, VA)
- …mandated by CMS and Conditions of Participation for discharge planning and utilization management . Addresses opportunities or potential concerns with leadership. ... and assessment of individuals in need of active Case Management services and promotes the right resources, at the...clinical setting (required) 3 years of experience in an acute care clinical setting (preferred) Ambulatory or post… more
- Bon Secours Mercy Health (Richmond, VA)
- …mandated by CMS and Conditions of Participation for discharge planning and utilization management . Addresses opportunities or potential concerns with leadership. ... and assessment of individuals in need of active Case Management services and promotes the right resources, at the...clinical setting (required) 3 years of experience in an acute care clinical setting (preferred) Ambulatory or post… more
- HCA Healthcare (Richmond, VA)
- …and concurrent review for all payers and maintains legible documentation as directed by the Utilization Management Plan + As a member of Case Management team ... + You will refer patients who require extended care post discharge to long-term care facilities. Once an appropriate...Graduate of an accredited school of nursing. + Commercial Utilization Management and/or Case Management … more
- ChenMed (Richmond, VA)
- …role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post -SNF needs. + ... of the nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed standards for… more
- Humana (Richmond, VA)
- …and interpretation skills with 5+ years of experience focusing on quality management , utilization management , discharge planning, rehabilitation services, ... attend Fair Hearings. The clinical scenarios arise from outpatient, post - acute care; acute inpatient; LTC...Clinical Integration, Long Term Services & Supports, and Case Management . The Medical Director, as indicated, could need to… more
- Sharecare (Richmond, VA)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager....in the orientation and to take the pre and post -test to review competency during orientation. Yearly competency test… more