- Humana (Richmond, VA)
- …require interpretation and independent determination of the appropriate courses of action. The Post - Acute Utilization Management Nurse 2: + Review ... caring community and help us put health first** The Utilization Management Nurse utilizes clinical nursing skills...1 or more years previous clinical experience in a Post - Acute clinical setting such as a SNF,… 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
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …transition of patients across the care continuum and ensures linkages with post - acute discharge providers. Essential Duties and Responsibilities These duties and ... + Effectively assess, plans, implement and evaluates strategies that ensure the appropriate utilization of clinical resources and management of length of stay. +… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …transition of patients across the care continuum and ensures linkages with post - acute discharge providers. Essential Duties and Responsibilities These duties and ... * Effectively assess, plans, implement and evaluates strategies that ensure the appropriate utilization of clinical resources and management of length of stay. *… 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
- 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
- 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
- Select Medical (Alexandria, VA)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...step-down, med surg, vents)** + Adequate experience in an acute medical case management setting and confidence… more
- Bon Secours Mercy Health (Petersburg, VA)
- …Moon, Bundle letters, and Conditions of Participation for DC Planning and Utilization Management , and address opportunities or potential concerns with ... with the physician and care team offering alternatives to acute care, and escalate to care management ...acute care clinical setting (preferred) + Ambulatory or post - acute , care coordination experience (preferred) **Training** EPIC… more
- Bon Secours Mercy Health (Newport News, VA)
- …+ Verifies patient's needs for acute level of care, collaborating with utilization management nurse to prevent potential denials. The care manager will ... the nursing staff to help them better understand the nuances of transition management , safe alternatives to acute care, proactive progression of care,… 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 (Petersburg, 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
- Select Medical (Alexandria, VA)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... Medical, we care for chronically and critically ill or post -ICU patients who require extended hospital care. Select Medical...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… 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
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …Experience: At least three years of clinical nursing experience required. Utilization management , discharge, planning, home health, and/or ambulatory experience ... expertise with knowledge of medical appropriateness criteria, and applies principles of utilization and quality management , discharge planning and the … 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
- Veterans Affairs, Veterans Health Administration (Hampton, VA)
- …City, NC. Hampton VAMC provides comprehensive health care which includes primary care, acute inpatient, acute psychiatric, chronic spinal cord injury, an 169-bed ... health education and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing the provision of nursing education,… more
- Guidehouse (Mclean, VA)
- …with partnership development and execution + Knowledge of health care operations across acute , post - acute , and ambulatory care settings. + Experience using ... analysis required to support the healthcare planning process, including utilization forecasts, capacity analysis, and in-migration/outmigration studies **What Would… more
- Intermountain Health (Richmond, VA)
- …and program evaluation. + Develops processes, tools, and policies for appropriate utilization management in collaboration with key stakeholders. + Supports ... and maintains positive relationships with medical staff, administration, hospital personnel, post - acute providers, payors, and other community entities. + Leads… more