- CVS Health (Richmond, VA)
- …in QI activities including data collection, tracking, and analysis. Telephonic clinical case management.- Uses Motivational Interviewing and engagement ... travel in the assigned region 25-40% of the time. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health… more
- Elevance Health (Richmond, VA)
- …or Friday-Tuesday 4:00 pm-12:30 am EST with 15% shift differential.** Please be aware this Behavioral Health Case Manager II position is for our Crisis Line ... of one of our Elevance Health PulsePoint locations. The Behavioral Health Case Manager II...II position is primarily member facing and involves complete clinical assessment. Also, they will be responsible for performing… more
- Elevance Health (Richmond, VA)
- …and depression, and insightful analytics to improve the delivery of care. The BH Case Manager I is responsible for performing case management telephonically ... 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)
- …**Introduction** Do you want to join an organization that invests in you as a(an) Clinical Care Case Manager PRN? At Chippenham Hospital, you come first. ... make a difference. We are looking for a dedicated Clinical Care Case Manager PRN...within designated time frame Requirements: + Minimum 2-5 years behavioral health clinical experience commensurate with educational… more
- HCA Healthcare (Richmond, VA)
- …with purpose and integrity. We care like family! Jump-start your career as a(an) Clinical Care Case Manager today with Chippenham Hospital. **Benefits** ... vary by location._** Come join our team as a(an) Clinical Care Case Manager . We...within designated time frame **Requirements:** + Minimum 2-5 years behavioral health clinical experience commensurate with educational… more
- Molina Healthcare (Petersburg, 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. We are looking for ... candidates who live in the Western region of Virginia. Case Manager RN will work in remote...per regulated timelines and determines who may qualify for case management based on clinical judgment, changes… more
- Molina Healthcare (Petersburg, VA)
- …VIRGINIA. We are looking for candidates who live in the Northern region of Virginia. Case Manager will work in remote and field setting supporting our Medicaid ... health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If… more
- Highmark Health (Richmond, VA)
- …**Required** + 5 years of Post licensure experience in any combination of behavioral health clinical , case management and/or condition management ... clinical and motivational interviewing skills to assess both behavioral and physical health needs, and social determinants of...Licensed Marriage and Family Therapist (LMFT) **Preferred** + Certified Case Manager + CAC - Certified Addiction… more
- Highmark Health (Richmond, VA)
- …year in home clinical or case management experience + Certified Case Manager (CCM) + Licensed Bachelors Social Worker (LBSW) + Licensed Masters Social ... referrals to special programs such as Disease/Chronic Condition Management, Behavioral Health, and Complex Case Management. +...Worker (LMSW) + Licensed Clinical Social Worker (LCSW) + Experience working with HIV/AIDS… more
- Humana (Richmond, VA)
- …This is a non-exempt position with responsibility for utilization management and clinical decision-making as outlined in the Autism Care Demonstration (ACD) defined ... TRICARE Operations Manual Chapter 18, section 4. This associate will conduct clinical necessity reviews for requested ABA services when approving all treatment plans… more
- Molina Healthcare (Sussex, 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
- Highmark Health (Richmond, VA)
- …Nursing **EXPERIENCE** **Required** + 7 years of any combination of clinical , case management and/or disease/condition management experience, provider operations ... of oncology 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
- CVS Health (Richmond, VA)
- …Country or surrounding areas (ie Pulaski, Christiansburg, Blacksburg) Position Summary Nurse Case Manager is responsible for telephonically and/or face to face ... assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical...policies and programs are comprised of network management and clinical coverage policies. Through the use of clinical… more
- HCA Healthcare (Richmond, VA)
- **Description** **Introduction** Do you have the career opportunities as a(an) Case Manager Registered Nurse RN you want in your current role? We invest in what ... 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
- Elevance Health (Richmond, VA)
- …Counites may include: Fairfax Winchester Rockingham Harrisonburg Culpeper The **Foster Care Case Manager ** is responsible for performing case management ... healthcare costs for the designated population via integrated (physical health/ behavioral health) case management and whole person...degree in nursing and minimum of 3 years of clinical experience in social work counseling with broad range… more
- Elevance Health (Richmond, VA)
- …required. Counties may include: Fairfax Winchester Rockingham Harrisonburg Culpeper The **Foster Care Case Manager II** is responsible for performing case ... healthcare costs for the designated population via integrated (physical health/ behavioral health) case management and whole person...degree in nursing and minimum of 5 years of clinical experience in social work counseling with broad range… more
- Molina Healthcare (Richmond, VA)
- …experience. **Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare Management ... Manager will support a team of field Nurse Case Managers supporting our Medicaid program We are looking...an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high… 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 ... oversight from immediate manager . + May be responsible for an entire clinical program and/or independently performs clinical reviews. + The Medical Director… more
- CenterWell (Richmond, VA)
- …program support through active communication, education, and consultation with clinical staff and leaders. Responsible for communicating with key stakeholders ... reducing acute care utilization, safe transitions, readmission reduction, and other clinical programs as determined. **Major Duties and Responsibilities** * Build… more