- CVS Health (VA)
- …No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral health clinical experience in a ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- Centene Corporation (Richmond, VA)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment… more
- Elevance Health (Palmyra, VA)
- …telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral ... **LTSS Service Coordinator - Clinician ** **Location:** The location for this position is...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
- Elevance Health (King George, VA)
- …an accommodation is granted as required by law._ The **LTSS Service Coordinator RN Clinician ** is responsible for overall management of member's case within the ... face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral … more
- Highmark Health (Richmond, VA)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more