- 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
- Cognizant (Richmond, VA)
- …- Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... 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
- 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 compact state… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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
- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Richmond, VA)
- …and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… 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
- 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 the ... months of hire) TNCC Trauma Nursing Core Course (preferred) CCRN Critical Care Registered Nurse (preferred) PCCN Progressive Care Certified Nurse (preferred)… 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 (Richmond, VA)
- …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 - St. ... (required) Bachelors of Science, nursing (preferred) **Minimum Years and Type of Experience** Registered Nurse with a minimum of 2 years Operating Room… more
- Bon Secours Mercy Health (Mechanicsville, VA)
- …care sites and clinicians are recognized for clinical and operational excellence. ** Registered Nurse (RN) Care Manager - Memorial Regional Medical Center** ... mandated by CMS and Conditions of Participation for discharge planning and utilization management . Addresses opportunities or potential concerns with leadership.… 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
- Bon Secours Mercy Health (Mechanicsville, VA)
- …create an environment where associates want to work and help communities thrive. ** Registered Nurse (RN) - Cardiac Surgery - Memorial Regional Medical Center** ... partnership * Interprofessional collaboration and leadership * Understanding and utilization of office and clinical technologies * Compassionate, relationship-based… more
- Bon Secours Mercy Health (Mechanicsville, VA)
- …(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 you find ... being alone. The continuing education and the ability to work with an experienced nurse provides you with confidence to ask questions, an ability to admit the things… 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 ... responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the… more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- Summary This Registered Nurse (Community Care Coordinator) (HAS Service) position is located at the Central Richmond VA Medical Center, Richmond, VA, within the ... activities of the local Office of Community Care (LOCC). Responsibilities The Registered Nurse is responsible for the planning, integrating, implementing,… 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
- Elevance Health (Richmond, VA)
- …on relatively complex case types that require the training and skill of a registered nurse . Acts as a resource for more junior Clinicians. **Primary duties ... initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes....of the utilization reviews within the medical management processes. + Assesses and applies medical policies and… more