• Manager, Utilization Management

    Humana (Richmond, VA)
    …to make an impact** **Required Qualifications** + An active, unrestricted Virginia Registered Nurse ( RN ) or Behavioral Health clinician license such as a ... health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management ( Behavioral Health) who will utilize their clinical skills to… more
    Humana (05/09/24)
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  • Registered Nurse RN Case…

    HCA Healthcare (Richmond, VA)
    …year, nurses at **Chippenham Hospital** have the opportunity to make a real impact. As a ** Registered Nurse RN Case Manager** you can be a part of change. ... benefits may vary by location._** We are seeking a ** Registered Nurse RN Case Manager**...experience in a hospital setting preferred.** + **Previous case management or utilization review experience preferred.** CJW… more
    HCA Healthcare (04/05/24)
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  • Case Manager Registered Nurse

    HCA Healthcare (Richmond, VA)
    **Description** **Introduction** Do you have the career opportunities as a(an) Case Manager Registered Nurse RN you want in your current role? We invest in ... RN years demonstrated leadership experience + Commercial Utilization Management and/or Case Management ...we encourage you to apply for our Case Manager Registered Nurse RN opening. We… more
    HCA Healthcare (05/01/24)
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  • PRN - Registered Nurse ( RN )

    Universal Health Services (Petersburg, VA)
    Responsibilities Registered Nurse ( RN ) - PRN Poplar Springs Hospital isa 183 bed acute care and residential facility. For more than 30 years Poplar Springs ... Position Requirements: Licensure/Certification/Registration: + Licensed to practice as a Registered Nurse ( RN ) in the...registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a… more
    Universal Health Services (05/08/24)
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  • Case Manager Registered Nurse

    HCA Healthcare (Hopewell, VA)
    …at TriCities Hospital have the opportunity to make a real impact. As a(an) Case Manager Registered Nurse RN PRN you can be a part of change. **Benefits** ... outcomes for your patients as a (an) Case Manager Registered Nurse RN PRN. We... RN years demonstrated leadership experience + Commercial Utilization Management and/or Case Management more
    HCA Healthcare (04/19/24)
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  • RN - Registered Nurse

    Bon Secours Mercy Health (Mechanicsville, VA)
    …ONE YEAR OF RN EXPERIENCE!** Summary of Primary Function The Obstetrics (OB) Registered Nurse ( RN ) addresses the care provided to healthcare consumers in ... as well as all people parenting newborns. The competent and proficient OB RN provides, coordinates, plans, and evaluates nursing care, and supervises licensed and… more
    Bon Secours Mercy Health (02/24/24)
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  • Cardiac Stress Registered Nurse

    Bon Secours Mercy Health (Richmond, VA)
    …patient teaching activities and coordinates the care provided by health team members. **Cardiac Stress Registered Nurse - RN - Cardiology Associate of VA - ... * Nursing judgment and skill based on principles of the biological, physical, behavioral , and social sciences * Application of the nursing process in patient care… more
    Bon Secours Mercy Health (05/09/24)
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  • New to Practice Registered Nurse

    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
    Bon Secours Mercy Health (04/14/24)
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  • PCU/Med Tele System Flex Traveling RN

    Bon Secours Mercy Health (Richmond, VA)
    …, to help our nurses grow, professionally and personally. **Tier 3 - System Flex Team traveler Registered Nurse ( RN )** A Tier 3 - System Flex Team Traveler ... Registered Nurse ( RN ) is expected...and skill based on principles of the biological, physical, behavioral , and social sciences + * Application of the… more
    Bon Secours Mercy Health (04/17/24)
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  • Behavioral Health Clinical Liaison, Roanoke…

    CVS Health (Richmond, VA)
    …Master's degree or Bachelor's degree ( Registered Nurses) or equivalent experience. + Registered Nurse ( RN ); BSN with strong psych background required ... a clinical leader in the Medicaid plan focusing on utilization management , integrating member care, clinical coordination,...behavioral health subject matter expert to support care management staff in serving Aetna members in the respective… more
    CVS Health (05/03/24)
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  • LTSS Service Coordinator - RN Clinician

    Elevance Health (Richmond, VA)
    …Must be located in the state of Virginia The **LTSS Service Coordinator - RN Clinician** is responsible for overall management of member's case within the ... or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral more
    Elevance Health (05/03/24)
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  • Managed Care Coordinator Clinician Non RN

    Elevance Health (Richmond, VA)
    … with telephonic assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, ... **Managed Care Coordinator Clinician Non RN ** **Location:** Remote, within 50 miles of an...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
    Elevance Health (05/10/24)
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  • Clinical RN , Comprehensive Care…

    Sharecare, Inc. (Richmond, VA)
    …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... with the participants and their Primary Care Provider according to the disease management program intervention guidelines. An RN is supervised by an Operations… more
    Sharecare, Inc. (05/09/24)
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  • Manager, Healthcare Services - Virginia Medicaid

    Molina Healthcare (Glen Allen, VA)
    **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse or LMHP who lives in VIRGINIA and must be licensed for the state of VIRGINIA. ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
    Molina Healthcare (04/25/24)
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  • Psychiatric Nurse Manager

    HCA Healthcare (Richmond, VA)
    …Assumes role of "charge" nurse and/or delegates various tasks to staff RN 's. Provides cross coverage for Utilization Review. + Maintains a competent staff ... obtained within 30 days of employment start date + Registered Nurse , Registered Nurse...or leadership. + Preferred - One year previous successful behavioral health nursing management experience, in an… more
    HCA Healthcare (03/22/24)
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  • Intensive Care Manager (Remote within Virginia)

    Kepro (Richmond, VA)
    …needed. Requirements + Current and Active Licensure for the State of Virginia : Registered Nurse ( RN ); Licensed Clinical Social Worker (LCSW); Licensed ... substance abuse healthcare settings. + Proficiency in DSM-5-TR, adeptness in utilization management procedures, and extensive experience collaborating with… more
    Kepro (05/01/24)
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  • Clinical Liaison - Field

    CVS Health (Richmond, VA)
    …mental health services and addiction recovery and treatment services through the utilization management process - Drives collaboration on quality of care, ... utilization management , disparities and care coordination to...behavioral health subject matter expert to support care management staff in serving Aetna members in the respective… more
    CVS Health (05/11/24)
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  • Pre-Authorization Nurse

    Humana (Richmond, VA)
    …projects. **Use your skills to make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin or have a compact license. ... community and help us put health first** Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the… more
    Humana (05/14/24)
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  • LTSS Service Coordinator - Clinician

    Elevance Health (Richmond, VA)
    …telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral ... is responsible for working under the direction/supervision of an RN , with overall responsibility for the member's case, as...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
    Elevance Health (05/03/24)
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  • Manager I, Foster Care Specialty Program (Central…

    Elevance Health (Richmond, VA)
    …care program in which members needs are identified, including physical health, behavioral health, social services for Virginia Foster Care. . Primary duties may ... include, but are not limited to: + Manages resource utilization to ensure appropriate delivery of care to members,...a related field, including at least 1 year people management experience. + Requires a BA/BS; or any combination… more
    Elevance Health (05/14/24)
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