- Humana (Richmond, VA)
- …us put health first** This is a non-exempt position with responsibility for utilization management and clinical decision-making as outlined in the Autism Care ... Responsibilities** Tasks include, but are not limited to: **70%** : Performing utilization management activities for assigned areas. Ensures full compliance with… more
- CVS Health (Richmond, VA)
- …of managed care experience highly preferred.- 2+ years of case management experience preferred.- Discharge planning experience preferred.- Utilization review, ... thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider… more
- Molina Healthcare (Glen Allen, VA)
- …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and...years in one or more of the following areas: utilization management , case management , care… more
- HCA Healthcare (Richmond, VA)
- …of management or leadership. + Preferred - One year previous successful behavioral health nursing management experience, in an acute care setting. Previous ... **Description** **Introduction** We are seeking a(an) Psychiatric Nurse Manager with Parham Doctors' Hospital to promote growth...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… 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)
- …to the appropriate next level of care. + Has working knowledge of utilization management functions and performs these duties as assigned; monitors patient ... care like family! Jump-start your career as a(an) Clinical Care Case Manager today with Chippenham Hospital. **Benefits** Chippenham Hospital, offers a total rewards… 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
- Elevance Health (Richmond, VA)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance...+ Requires MA/MS social work counseling or a related behavioral health field or a degree in nursing, and… more
- CenterWell (Richmond, VA)
- …Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as ... ER visits, readmissions, total cost of care, and reducing acute care utilization ). * Familiarity in integrated care management programs with primary… 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
- Kepro (Richmond, VA)
- …substance abuse healthcare settings. + Proficiency in DSM-5-TR, adeptness in utilization management procedures, and extensive experience collaborating with ... in the public sector. Acentra seeks an Intensive Care Manager (Remote within Virginia) to join our growing team....of 2 years of hands-on experience in Intensive Care Management and post-degree in healthcare; behavioral health,… more
- Ford Motor Company (Richmond, VA)
- …is best-in-class. **In this position ** The Accessories eCommerce Merchandising Manager is responsible for deeply understanding customer needs and optimizing the ... business value daily by pulling, analyzing, and translating web analytics and behavioral data into actionable insights to enhance sales, conversion, and customer… more
- CenterWell (Richmond, VA)
- …health and full-risk frameworks, including patient engagement, clinical professional skillsets, utilization management , care management , clinical information ... the complex needs of seniors and improve health outcomes and avoidable utilization (eg, palliative care, post-acute care, transitions of care) at a population… more
- HCA Healthcare (Richmond, VA)
- …standards, contract compliance, patient satisfaction, employee engagement, retail margin management , patient service utilization and complimentary service ... 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… more
- Elevance Health (Richmond, VA)
- …role required by a State agency. **Preferred Skills, Capabilities, and Experiences:** + Utilization Management experience is a plus. + Ability to meet necessary ... **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective… more
- Universal Health Services (Petersburg, VA)
- …guided by its mission of helping those who need the full continuum of behavioral health services. Our facility offers behavioral and psychological treatment for ... provision of quality nursing care to assigned groups of patients/residents through utilization of the nursing process, established standards of care, and relevant… more
- HCA Healthcare (Richmond, VA)
- …of clinical operations and provides support to hospital facilities operations management related to physicians who practice within hospital and outpatient settings. ... Responsibilities include oversight of the operations, budget, and general management of a portfolio of practices within a defined geographic area or specialty. This… more
- Molina Healthcare (Glen Allen, VA)
- …SKILLS & ABILITIES** : 1-3 years in case management , disease management , managed care or medical or behavioral health settings. **REQUIRED LICENSE, ... and HEDIS data to inform targeted interventions to increase utilization of well-child visits, screenings, exams, and associated services;...: 3-5 years in case management , disease management , managed care or medical or behavioral … 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
- 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