• Clinical Review Nurse…

    Centene Corporation (Richmond, VA)
    …- 5pm Eastern with some holidays on a rotating basis.** + **Previous concurrent review experience is highly preferred.** **Position Purpose:** Performs ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
    Centene Corporation (10/03/25)
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  • Utilization Management Nurse Consultant

    CVS Health (Richmond, VA)
    …clinical criteria to evaluate outpatient and inpatient services requiring precertification and concurrent review . + Conduct clinical reviews via phone and ... members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key Responsibilities**...At least 1 year of Utilization Management experience in concurrent review or prior authorization. + Strong… more
    CVS Health (10/01/25)
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  • RN Case Manager

    ChenMed (Hampton, VA)
    …departments, external service organizations, agencies and healthcare facilities. + Conduct concurrent medical record review using specific indicators and ... clinical resources and mobilizes resources to assist in achieving desired clinical outcomes within specific timeframe. + Conducts review for appropriate… more
    ChenMed (09/23/25)
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  • Revenue Integrity Charge Analyst - RN

    HCA Healthcare (Richmond, VA)
    …a part of our team. **Job Summary and Qualifications** The Revenue Integrity Clinical Charge Analyst RN is responsible for determining the appropriateness of patient ... protocol, corporate standards and other applicable documentation. Provides charge review results and develops and coordinates educational in-services for facility… more
    HCA Healthcare (10/04/25)
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