• Utilization Management…

    Humana (Richmond, VA)
    …us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (10/17/25)
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  • Registered Nurse (RN) - Behavioral…

    Bon Secours Mercy Health (Portsmouth, VA)
    …$20,000.00 sign on bonus **Summary of Primary Function/General Purpose of Position** The Behavioral Health Registered Nurse (RN) functions as a care provider of ... Collects and records nursing assessment of the physical and behavioral health status of the patient. +...patient outcomes are met. + Participates in the safe management of the milieu, intervening effectively with patients who… more
    Bon Secours Mercy Health (10/12/25)
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  • Registered Nurse (RN) - Behavioral…

    Bon Secours Mercy Health (Portsmouth, VA)
    …Sign on bonus eligible **Summary of Primary Function/General Purpose of Position** The Behavioral Health Registered Nurse (RN) functions as a care provider of ... Collects and records nursing assessment of the physical and behavioral health status of the patient. *...patient outcomes are met. * Participates in the safe management of the milieu, intervening effectively with patients who… more
    Bon Secours Mercy Health (09/09/25)
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  • Behavioral Health Case Manager…

    Elevance Health (VA)
    ** Behavioral Health Case Manager I (ARTS)** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... **Preferred Locations:** Richmond, VA, Roanoke, VA, Norfolk, VA The ** Behavioral Health Case Manager I (ARTS)** is...Case Manager I (ARTS)** is responsible for performing case management telephonically and/or by home visits within the scope… more
    Elevance Health (10/04/25)
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  • Behavioral Health Clinical Quality…

    Elevance Health (Norfolk, VA)
    …and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed care setting ... **JR167284 Behavioral Health Clinical Quality Audit Analyst, Sr** Responsible for maintaining crisis accreditation and developing, delivering and evaluating… more
    Elevance Health (10/13/25)
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  • Management Analyst II

    Fairfax County Sheriff's Office (Fairfax, VA)
    …Behavioral Health Expertise: A solid understanding of children's behavioral healthcare, case management , and evidence-based practices. + Critical Thinking ... Management Analyst II Print (https://www.governmentjobs.com/careers/fairfaxcounty/jobs/newprint/5104066) Apply  ...Quality Improvement (CQI) Analyst - Join Us in Improving Behavioral Health Services for Youth! Are you… more
    Fairfax County Sheriff's Office (10/12/25)
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  • Medical Director, Medical Management

    Highmark Health (Richmond, VA)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
    Highmark Health (10/15/25)
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  • RN Director Clinical Practice (Home Health…

    BrightSpring Health Services (Arlington, VA)
    …pharmacy, home health care and primary care, and rehabilitation and behavioral health , we provide comprehensive and more integrated care and clinical ... utilization and hospital admission reduction. + Provides survey management support/ follow-up/and coordination of corrective actions plans relatied to care… more
    BrightSpring Health Services (08/26/25)
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  • National Accounts Medical Director

    Elevance Health (Norfolk, VA)
    …to day clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for ... medical director provides clinical expertise in all aspects of utilization review and case management . Provides input...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
    Elevance Health (09/23/25)
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  • Transplant Care Nurse - Remote

    Highmark Health (Richmond, VA)
    …of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... health status/severity and clinical needs; and assesses health management needs of the assigned member...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
    Highmark Health (10/10/25)
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