- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Richmond, VA)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST/CST zones… 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
- CenterWell (Richmond, VA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- Elevance Health (Norfolk, VA)
- ** Utilization Management Representative I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law._ The ** Utilization Management Representative I** will be responsible...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Sharecare (Richmond, VA)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… 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 VA ... the local Office of Community Care (LOCC). Responsibilities The Registered Nurse is responsible for the planning, integrating, implementing, modifying, and… more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- …of the RAI/MDS process and software. Downloading, validating, and distributing quality management and Resource Utilization Group (RUG) reports and distributing ... Assessment Coordinator (RAC) directly responsible and accountable to the Chief Nurse for Geriatrics and Extended Care. Responsibilities The CLC Resident Assessment… more
- Battelle Memorial Institute (Arlington, VA)
- …as a case manager by a recognized certifying organization, ie, Commission for Case Management Certification or American Nurse Credentialing Center + At least two ... Research and Analytics (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support of our government customer,… more
- Veterans Affairs, Veterans Health Administration (Fredericksburg, VA)
- …responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Duties include ... locations may be required to drive and/or ride in GSA-vehicles. Registered Nurse (RN) is responsible for providing competent, evidence-based care to assigned… more
- ChenMed (Virginia Beach, VA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner, Specialty incumbent adheres to strict departmental goals/objectives, standards ... we need great people to join our team. The Nurse Practitioner (NP), Specialty acts as part of the...nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed… more
- Somatus (Fairfax, VA)
- …physical and mental well-being + Community engagement opportunities + And more! The Nurse Navigator is a critical member of the Somatus care team, serving both ... a patient advocate and a strategic partner to case management teams and hospital staff. This role collaborates with...kidney disease (CKD) and end-stage kidney disease (ESKD). The Nurse Navigator works with hospital staff, patients, and caregivers… more
- ChenMed (Norfolk, VA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... and we need great people to join our team. ESSENTIAL JOB FUNCTIONS: The Nurse Practitioner (NP) acts as part of the clinical operations team and is responsible… more
- ChenMed (Norfolk, 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...nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed… 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...nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed… more
- Erickson Living (Springfield, VA)
- …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review, and Performance Improvement/Risk Management /Safety (PI/RM/S) Committee ... by Erickson Senior Living Join our team as the Nurse Manager, RN also known as the Clinical Manager!...and processes in accordance with the Erickson Senior Living Management Policies and Procedures and nursing standards of practice.… more
- Bon Secours Mercy Health (Portsmouth, VA)
- …TO APPLY **Summary of Primary Function/General Purpose of Position** The Registered Nurse Medical/Surgical functions as a care provider of a multidisciplinary care ... provision of patient care, demonstrates strong skills related to effective time management and prioritizing patient care, contributes to the provision of quality… more
- Bon Secours Mercy Health (Portsmouth, VA)
- …**Summary of Primary Function/General Purpose of Position** The Behavioral Health Registered Nurse (RN) functions as a care provider of a multidisciplinary care team ... procedures, guidelines of the organization, and within the State's Nurse Practice Act. The RN provides a safe and...patient outcomes are met. + Participates in the safe management of the milieu, intervening effectively with patients who… more