- Elevance Health (Norfolk, VA)
- ** Telephonic Nurse Case Manager Senior** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager Senior** is responsible for care management within the scope… more
- Elevance Health (Norfolk, VA)
- ** Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... members in different states; therefore, Multi-State Licensure will be required.** The ** Telephonic Nurse Case Manager II** is responsible for care management within… more
- Elevance Health (Norfolk, VA)
- ** Telephonic Nurse Case Manager II** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
- Sedgwick (Richmond, VA)
- …line of business experience in telephonic case management (TCM) and/or utilization review or equivalent combination of education and experience required. ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Quality Review Nurse **PRIMARY PURPOSE** : To monitor team and colleague technical and… more
- Highmark Health (Richmond, VA)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the...of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The… more
- Sharecare (Richmond, VA)
- …and objectives of the Disease Management program by providing high quality telephonic and omni - channel support in an appropriate, efficient and cost-effective ... nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- Somatus (Mclean, VA)
- …+ Travel (up to 25%) to local renal care providers for quality oversight and utilization review collection + Other duties as assigned. _Please note this job ... and policies of Somatus + Assist Directors of Quality on quality and utilization audits as assigned, including targeted audits as requested by the Director. +… more
- CVS Health (Salem, VA)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... appropriate under the direct supervision of a licensed pharmacist + Taking telephonic prescriptions from the prescriber, and calling the prescriber to clarify… more
- KSA Integration LLC (Arlington, VA)
- …experience post degree in psychiatric and/or substance abuse health care setting, including utilization review . + Requires a Master's level clinician with a MA, ... Department of Labor "Hire Vets" Platinum Medallion Award. Position Overview:Provides telephonic support to Service Members and Veterans during periods of transition,… more