- Evolent Health (Richmond, VA)
- …contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager , Utilization ... the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as...medical reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs, and Clinical… more
- Highmark Health (Richmond, VA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements the effective utilization management strategies including: review of appropriateness of health ... years of post licensure experience in a combination of Behavioral Health Clinical, Case Management and/or Condition...Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +… more
- CVS Health (Richmond, VA)
- …thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider ... and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. - Monitor… more
- CVS Health (Richmond, VA)
- …involving clinical issues * Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk ... clinical/medical programs * Provide psychiatric leadership to an interdisciplinary utilization management team, including medical/clinical oversight, consultation… more
- Elevance Health (Richmond, VA)
- **Anticipated End Date:** 2024-09-15 **Position Title:** Behavioral Health Medical Director - Child & Adolescent Psychiatry **Job Description:** Wellpoint, formerly ... responsible for appeals reviews within our Medicaid and Medicare programs.** The ** Behavioral Health Medical Director** is responsible for the administration of … more
- HCA Healthcare (Richmond, VA)
- …review for all payers and maintain legible documentation as directed by the Utilization Management Plan. **What qualifications you will need:** + Graduate of ... PRN career opportunities as a **Social Worker SW Case Manager PRN** you want with your current employer? We...in an acute care setting preferred. + Previous case management or utilization review experience preferred. CJW… more
- HCA Healthcare (Richmond, VA)
- …review for all payers and maintain legible documentation as directed by the Utilization Management Plan. **What qualifications you will need:** + Graduate of ... PRN career opportunities as a **Social Worker SW Case Manager PRN** you want with your current employer? We...in an acute care setting preferred. + Previous case management or utilization review experience preferred. CJW… more
- HCA Healthcare (Richmond, VA)
- …review for all payers and maintain legible documentation as directed by the Utilization Management Plan. **What qualifications you will need:** + Graduate of ... Submit your application for our **Social Worker SW Case Manager ** opening with Chippenham Hospital today and find out...in an acute care setting preferred. + Previous case management or utilization review experience preferred. CJW… more
- HCA Healthcare (Richmond, VA)
- …to the appropriate next level of care. + Has working knowledge of utilization management functions and performs these duties as assigned; monitors patient ... that invests in you as a(an) Clinical Care Case Manager PRN? At Chippenham Hospital, you come first. HCA...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
- HCA Healthcare (Richmond, VA)
- …where diversity and inclusion thrive? Submit your application for our Performance Improvement Manager Labor opening with HCA Healthcare today and find out what it ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...vary by location._** We are seeking a(an) Performance Improvement Manager Labor for our team to ensure that we… 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 ... Do you have the career opportunities as a(an) Case Manager Registered Nurse RN you want in your current...experience as RN years demonstrated leadership experience + Commercial Utilization Management and/or Case Management … more
- HCA Healthcare (Richmond, VA)
- …of RN experience in a hospital setting preferred.** + **Previous case management or utilization review experience preferred.** CJW Medical Center ... a real impact. As a Registered Nurse RN Case Manager you can be a part of change. **Benefits**...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
- Highmark Health (Richmond, VA)
- …includes leveraging cutting-edge customer experience platforms, implementing robust data management solutions, and optimizing marketing automation tools to drive ... department. This role will be responsible for managing our MarTech ecosystem, including management and delivery of agreed upon road maps and platform integrations to… more
- Ford Motor Company (Richmond, VA)
- …are as smart as you are. The Merchandise eCommerce Merchandising & Product Manager is responsible for deeply understanding customer needs, managing the day-to day ... day by pulling, analyzing, and translating web analytics and behavioral data into actionable insights to enhance sales, conversion,...experience + 3+ years of eCommerce Merchandising AND Product Management experience + 1+ years of Shopify Site … more
- Highmark Health (Richmond, VA)
- …actions (promotions, hiring, terminations, etc.) Develops talent, Addresses resource management , cultivates capabilities of staff, planning and coordination of work, ... in first-line resolution of complex technical problems 2. Provides Staff Management oversight * Hires, promotes, separates or makes recommendations regarding same… more
- Elevance Health (Colonial Heights, VA)
- …face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral ... VA. The **LTSS Service Coordinator RN Clinician** is responsible for overall management of member's case within the scope of licensure; provides supervision and… more
- Elevance Health (Richmond, VA)
- …The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective ... to Medical Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical program and/or independently… more
- HCA Healthcare (Richmond, VA)
- …at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical ... include being directly responsible to the Director of Pharmacy services and Clinical Manager of Pharmacy. The pharmacist is also responsible for the supervision of… more
- HCA Healthcare (Richmond, VA)
- …at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical ... include being directly responsible to the Director of Pharmacy services and Clinical Manager of Pharmacy. The pharmacist is also responsible for the supervision of… more
- Guardian Life (Richmond, VA)
- …certification in profession, such as Certified Rehabilitation Counselor (CRC),Certified Disability Management Specialist (CDMS), Certified Case Manager (CCM). + ... attitude. You can collaborate with stakeholders to provide effective case management within the boundaries of contractual definitions. **You will:** + Assess… more