- Humana (Richmond, VA)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- CVS Health (Richmond, VA)
- …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Cognizant (Richmond, VA)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Richmond, VA)
- …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- …position. Permanent Change of Station (PCS): Not Authorized Preferred Experience: Utilization Management per the paperwork. Requirements Conditions of Employment ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care....level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- CVS Health (Richmond, VA)
- …will be for 11-8pm EST M-F** **Required Qualifications** 1+ years experience as a Registered Nurse , with an unrestricted license in state of residence. 1+ years ... of clinical experience **Preferred Qualifications** Utilization Management experience Managed Care Experience Proficiency in grammar and syntax Ability to… more
- Bon Secours Mercy Health (Mechanicsville, VA)
- …hospitals, care sites and clinicians are recognized for clinical and operational excellence. ** Registered Nurse ( RN ) Care Manager - Memorial Regional Medical ... Center** **$10,000 sign-on bonus!** The RN Care Manager is responsible for providing coordination of...CMS and Conditions of Participation for discharge planning and utilization management . Addresses opportunities or potential concerns… more
- CVS Health (Richmond, VA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital… more
- CVS Health (Richmond, VA)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating… more
- Bon Secours Mercy Health (Petersburg, VA)
- …**Full-time night shift/12hr shifts** **Summary of Primary Functions** The Critical Care Registered Nurse ( RN ) provides, coordinates, plans, and evaluates ... Nurse (preferred) PCCN Progressive Care Certified Nurse (preferred) RN -BC Registered Nurse - Board Certified (preferred) TCRN Trauma Certified… more
- Bon Secours Mercy Health (Richmond, VA)
- …clinical and operational excellence. **Summary of Primary Function** In the capacity of a Registered Nurse ( RN ), the Ambulatory Care Manager will provide ... clinical care management services to identified eligible patients; coordinating care to...Nursing Bachelor's Degree (preferred) Specialty/Major- Nursing (BSN) **Licensing/ Certification** Registered Nurse with active License in State… more
- Bon Secours Mercy Health (Richmond, VA)
- …care sites and clinicians are recognized for clinical and operational excellence. Job Description ** Registered Nurse ( RN ) - FT - Orthopedic Operating Room - ... (required) Bachelors of Science, nursing (preferred) **Minimum Years and Type of Experience** Registered Nurse with a minimum of 2 years Operating Room… more
- ChenMed (Richmond, VA)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- Bon Secours Mercy Health (Mechanicsville, VA)
- …to create an environment where associates want to work and help communities thrive. ** Registered Nurse ( RN ) - Cardiac Surgery - Memorial Regional Medical ... partnership * Interprofessional collaboration and leadership * Understanding and utilization of office and clinical technologies * Compassionate, relationship-based… more
- Bon Secours Mercy Health (Mechanicsville, VA)
- …Education (ACE) Program** **is a 12-week program designed specifically to support the new-to-practice Nurse in preparation for a RN bedside role. ACE will help ... FOR A BONUS UP TO $15K FOR NEW GRAD RN 'S WITH LESS THAN 1 YEAR OF RN...education and the ability to work with an experienced nurse provides you with confidence to ask questions, an… more
- CVS Health (Richmond, VA)
- …Liaison is a clinical leader in the Medicaid plan focusing on utilization management , integrating member care, clinical coordination, leading the development, ... mental health services and addiction recovery and treatment services through the utilization management process + Drives collaboration on quality of care,… more
- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Fresenius Medical Center (Richmond, VA)
- …and post procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... acting on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other FVC administrative and… more