- 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...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- CVS Health (Richmond, VA)
- …state of residence. 1+ years of clinical experience **Preferred Qualifications** Utilization Management experience Managed Care Experience Proficiency in grammar ... services. Maintains accurate and complete documentation to meet risk management , regulatory, and accreditation requirements. Promotes communication, both internally… 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
- 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...at a time that is best for your schedule. **Work-At- Home / Internet Information:** To ensure Home … 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
- Sharecare (Richmond, VA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… 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 ... of recent clinical experience as RN years demonstrated leadership experience + Commercial Utilization Management and/or Case Management experience; Quality … 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 ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- ChenMed (Richmond, VA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... we need great people to join our team. The Nurse Practitioner (NP) acts as part of the clinical...medical centers, nursing homes, skilled nursing facilities (SNF) and home settings depending on the nature of the assignment… more
- ChenMed (Richmond, VA)
- …expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional patient care advice ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
- Bon Secours Mercy Health (Richmond, VA)
- … certification (CCM) (preferred) **Minimum Qualifications** 2-3 years acute care, home health or case management experience (required) **Other Knowledge, ... excellence. **Summary of Primary Function** In the capacity of a Registered Nurse (RN), the Ambulatory Care Manager will provide clinical care management… more
- ChenMed (Colonial Heights, VA)
- …informed decisions re: goals of care, palliative care and hospice. + Utilization /Financial Management -managing resource utilization and reimbursement for ... occasionally in acute care, nursing homes, skilled nursing facilities (SNF) and home settings depending on the nature of the assignment. The responsibilities include… more
- Evolent (Richmond, VA)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… 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, ... call weekend and holiday weekend coverage required. **Work at Home Requirements:** + Candidate will work from home...services and addiction recovery and treatment services through the utilization management process + Drives collaboration on… more
- HCA Healthcare (Richmond, VA)
- …labor management , including position control, scheduling excellence, productivity management , and premium pay utilization . Maintains staffing to ensure ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- HCA Healthcare (Richmond, VA)
- …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... and adoption assistance. + Referral services for child, elder and pet care, home and auto repair, event planning and more + Consumer discounts through Abenity… more