- Humana (Richmond, VA)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Richmond, VA)
- …we do it all with heart, each and every day. **Position Summary** The ** Utilization Management Clinical Nurse Consultant** utilizes clinical skills to ... Arizona Time Zone. **Preferred Qualifications** : + Previous experience with utilization management . + Previous clinical experience in Emergency Department,… more
- CVS Health (Richmond, VA)
- …state of residence. 1+ years of clinical experience **Preferred Qualifications** Utilization Management experience Managed Care Experience Proficiency in grammar ... services. Maintains accurate and complete documentation to meet risk management , regulatory, and accreditation requirements. Promotes communication, both internally… more
- CenterWell (Richmond, VA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Evolent (Richmond, VA)
- …As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Clinical reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- Summary Registered Nurse - Float Pool Demonstrates integration of biopsychosocial concepts, cognitive skills, and technically competent practice while providing care ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Responsibilities… more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- …education, orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates knowledge, skills, abilities, and ... Summary The Registered Nurse - Polytrauma Transitional Rehabilitation Program (PTRP) at...responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice… more
- ChenMed (Richmond, VA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... we need great people to join our team. The Nurse Practitioner (NP) acts as part of the clinical...nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed… more
- ChenMed (Richmond, VA)
- …expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional patient care advice ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
- Bon Secours Mercy Health (Petersburg, VA)
- …night shift/12hr shifts** **Summary of Primary Functions** The Critical Care Registered Nurse (RN) provides, coordinates, plans, and evaluates the care of the ... life supporting technology/modalities may include but not limited to: ventilator management , CRRT, IABP, Impella, ECMO * Performs hemodynamic monitoring * Clinically… more
- Elevance Health (Richmond, VA)
- …solving with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. + Within the medical ... **Transplant Nurse II** **Location:** Virtual: This role enables associates...II** will be responsible for providing case and/or medical management for members receiving transplant services. Continue to learn… more
- Bon Secours Mercy Health (Richmond, VA)
- …excellence. **Summary of Primary Function** In the capacity of a Registered Nurse (RN), the Ambulatory Care Manager will provide clinical care management ... Interviewing techniques as a patient-centered approach to activate patients in self- management of their chronic conditions with the goal of improved symptom… more
- ChenMed (Colonial Heights, VA)
- …informed decisions re: goals of care, palliative care and hospice. + Utilization /Financial Management -managing resource utilization and reimbursement for ... of the plan of care, health education, specialty referrals, case management referrals, follow-up and clear documentation according to ChenMed standards for… more
- Evolent (Richmond, VA)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Bon Secours Mercy Health (Mechanicsville, VA)
- …(ACE) Program** **is a 12-week program designed specifically to support the new-to-practice Nurse in preparation for a RN bedside role. ACE will help you find ... being alone. The continuing education and the ability to work with an experienced nurse provides you with confidence to ask questions, an ability to admit the things… more
- Bon Secours Mercy Health (Mechanicsville, VA)
- …mandated by CMS and Conditions of Participation for discharge planning and utilization management . Addresses opportunities or potential concerns with leadership. ... and clinicians are recognized for clinical and operational excellence. **Registered Nurse (RN) Care Manager - Memorial Regional Medical Center** **$10,000 sign-on… more
- Bon Secours Mercy Health (Richmond, VA)
- …clinicians are recognized for clinical and operational excellence. Job Description **Registered Nurse (RN) - FT - Orthopedic Operating Room - St. Mary's Hospital** ... partnership * Interprofessional collaboration and leadership * Understanding and utilization of office and clinical technologies * Compassionate, relationship-based… more
- Fresenius Medical Center (Richmond, VA)
- …procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in optimum ... acting on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other FVC administrative and… more
- Elevance Health (Richmond, VA)
- …in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and ... ensures essential face-to-face onboarding and skill development._ The **Medical Management Clinician Sr** is responsible for ensuring appropriate, consistent… more