- Chesapeake Regional Healthcare (Chesapeake, VA)
- Summary The Utilization Review Nurse combines clinical expertise with knowledge of medical appropriateness criteria, and applies principles of utilization ... resources as a facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of… more
- CVS Health (Richmond, VA)
- … Management Nurse Consultant (UMNC) position is 100% remote. As a Utilization Nurse Consultant, you will utilize clinical skills to coordinate, document and ... MS Office suites experience including Outlook and Excel **Preferred Qualifications** + Utilization Review experience + Managed Care experience + Strong customer… more
- Humana (Richmond, VA)
- …Provider calls **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) compact license with no disciplinary action ... independent determination of the appropriate courses of action. The Post-Acute Utilization Management Nurse 2: + Review Post-Acute Preauth cases using… more
- Serco (VA)
- …+ Education, Licensure, and Certification: + Bachelor's Degree in Nursing + Current Registered Nurse Licensure + Certified Professional Coder (CPC) or Certified ... of supervisory/managerial experience in the health insurance industry, a utilization review firm, or another health care...3 years of experience practicing nursing as a licensed Registered Nurse . + Extensive knowledge of the… more
- HCA Healthcare (Richmond, VA)
- …every year, nurses at Chippenham Hospital have the opportunity to make a real impact. As a Registered Nurse RN Case Manager you can be a part of change. ... benefits may vary by location._ We are seeking a Registered Nurse RN Case Manager...a hospital setting preferred.** + **Previous case management or utilization review experience preferred.** CJW Medical Center… more
- LifePoint Health (Warrenton, VA)
- …state or local law./ **Job:** **Nursing Management* **Organization:** ** **Title:** * Registered Nurse ( RN ) Case Manager* **Location:** *Virginia-Warrenton* ... Experience* *Required*- Three years of nursing experience. *Preferred*- Experience in utilization review , case management, discharge planning, and clinical… more
- Bon Secours Mercy Health (Newport News, VA)
- …**This is a PRN position at Mary Immaculate Hospital** **Licensing/ Certification** + Acute Registered Nurse ( RN ) (required) + BLS Basic Life Support - ... rules and regulations and Conditions of Participation for DC Planning and Utilization Review , and address opportunities or potential concerns with leadership.… more
- LifePoint Health (Danville, VA)
- * Registered Nurse , RN - Utilization Review Case Manager* Job Type:Full Time|Days *$10,000 Sign-on Bonus Eligibility for Full-Time, Bedside RNs* ** ... Must have Utilization Review experience.** ** * ** *Your...valued as an employee, but as a person. As a* registered nurse ( RN )*joining our team,… more
- CenterWell (Roanoke, VA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- HCA Healthcare (Richmond, VA)
- …your career path, we encourage you to apply for our Case Manager Registered Nurse RN PRN opening. We review all applications. Qualified candidates will ... you have the career opportunities as a(an) Case Manager Registered Nurse RN PRN you...in this role is to Performs admission and concurrent review for all payers and maintains legible documentation as… more
- Veterans Affairs, Veterans Health Administration (Salem, VA)
- Summary Excited to Announce Salem VA Medical Center is looking for a Registered Nurse ( RN ) Referral Coordinator. RN influences care outcomes by ... programs. Responsibilities The Registered Nurse Referral Coordination Team (RCT) Registered Nurse ( RN ) is responsible for executing a streamlined… more
- Bon Secours Mercy Health (Richmond, VA)
- …stewardship to create an environment where associates want to work and help communities thrive. ** Registered Nurse ( RN ) - Physician Office - Bon Secours - ... Cardiology, Reynolds - Richmond, VA** **_Are you an RN with Oncology experience? If you have any interest...cardiology step down or critical care experience as a Registered Nurse + Experience within a physician… more
- Select Medical (Newport News, VA)
- …Illness Recovery Hospital** **Director of Case Management** **_Clinical license as a registered nurse or respiratory therapist or master's in social work ... and professional growth of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan… more
- Fresenius Medical Center (Chesapeake, VA)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Fresenius Medical Center (Alexandria, VA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Humana (Newport News, VA)
- …supports the goal to put health first? The Prior Authorization, Registered Nurse , RN , Intern will review prior authorization requests for appropriate ... onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN , Intern will...using clinical judgment and refers to internal stakeholders for review depending on case findings. + Educates providers on… more
- Veterans Affairs, Veterans Health Administration (Salem, VA)
- … of the EDRP application. Former EDRP participants ineligible to apply Responsibilities Registered Nurse ( RN ) is responsible for providing competent, ... as appropriate to the setting. Duties listed below but not limited to: The Registered Nurse will assist in directing the provision of nursing education,… more
- Elevance Health (Richmond, VA)
- …Focuses on relatively complex case types that require the training and skill of a registered nurse . Acts as a resource for more junior Clinicians. **How you'll ... a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid... experience. + Current active, valid and unrestricted + RN license and/or certification to practice as a health… 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/) is ... prevent or decrease ACDs as appropriate. + You will perform admission and concurrent review for all payers and maintain legible documentation as directed by the … more
- Elevance Health (Norfolk, VA)
- …Health PulsePoint office. This utilization management role is responsible for utilization management review for Behavior Analysis services. **How you will ... equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA (as allowed by...is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with… more