- 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)
- …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)
- …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
- HCA Healthcare (Richmond, VA)
- …nurses at Johnston-Willis Hospital have the opportunity to make a real impact. As a Registered Nurse RN Case Manager you can be a part of change. **Benefits** ... and improve positive outcomes for your patients as a Registered Nurse RN Case Manager. We want...experience in a hospital setting preferred. + Previous case management or utilization review experience preferred. Johnston-Willis… 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
- 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 (Midlothian, VA)
- …years cardiac surgery and/or cardiology step down or critical care experience as a Registered Nurse + Experience within a physician practice setting. + Working ... partnership + Inter-professional collaboration and leadership + Understanding and utilization of office and clinical technologies + Compassionate, relationship-based… more
- Fresenius Medical Center (Louisa, VA)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Evolent (Richmond, VA)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed… more
- Bon Secours Mercy Health (Richmond, VA)
- …Basic Life Support - American Heart Association (required) + Currently Licensed as a Registered Nurse in the State of Practice (required) + ACLS Advanced Cardiac ... Summary:** The Surgery Supervisor is responsible for oversite of the staff and management of day-to-day operations of the unit in accordance with federal, state, and… more
- Highmark Health (Richmond, VA)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- HCA Healthcare (Richmond, VA)
- …- Preferred Experience in Project Management - Preferred Currently Licensed as a Registered Professional Nurse in VA - Required BLS - Required ACLS - ... the Trauma Center. This position maintains responsibility/accountability for 24-hour/7-day management . Demonstrates excellence in strategic planning and coordination for… more
- Humana (Richmond, VA)
- …**Use your skills to make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin, including compact license. + Two ... inpatient and subacute activity daily for outcomes related to readmission, utilization , quality of care and provider performance in compliance with Humana/iCare… more
- Bon Secours Mercy Health (Richmond, VA)
- …nursing (preferred) **Licensure/Certification:** + Must possess both of the following: + Active Registered Nurse (RN) licensure + Basic Life Support (BLS) - ... partnership + Interprofessional collaboration and leadership + Understanding and utilization of office and clinical technologies + Compassionate, relationship-based… more