- Humana (Richmond, VA)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- CVS Health (Richmond, VA)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in Eastern Standard Time… more
- Elevance Health (Woodbridge, VA)
- … management or case management experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination ... is located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of...the District of Columbia is required. **Preferred Qualifications:** + Utilization Management /Review in managed care strongly preferred.… more
- Humana (Richmond, VA)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
- ChenMed (Norfolk, VA)
- …setting experience is preferred. + Minimum of two ( 2 ) years of utilization review, case management , home health and/or discharge planning experience is ... of communication. + Introduce self to patient/family and explain nurse case manager role and process to contact ...experience required. + A minimum of 1 year of utilization review and/or case management , home health,… more
- Veterans Affairs, Veterans Health Administration (Salem, VA)
- …AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN and 1 year of professional nursing experience ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care....equivalent to the Nurse I, Level 2 ; OR a Master's… more
- Humana (Richmond, VA)
- …of our caring community and help us put health first** The Senior Compliance Nurse reviews utilization management activities and documentation to ensure ... and detect fraud, waste, and abuse. The Senior Compliance Nurse work assignments involve moderately complex to complex issues...Minimum two, ( 2 ) years of experience in utilization management + Intermediate proficiency using Microsoft… more
- KBR (Virginia Beach, VA)
- …organization, ie Commission for Case Management Certification, American Case Management Association or American Nurse Credentialing Center, or shall obtain ... Title: Special Operations Nurse Case Manager (JEB Little Creek, VA) THIS...care goals. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential… more
- University of Virginia (Charlottesville, VA)
- A dynamic professional clinician focused on population management with demonstrated capability to provide relationship-based care within a collaborative ... multidisciplinary team. This registered nurse utilizes advanced critical thinking to develop, implement, and evaluate an individualized plan of care that educates,… more
- Intermountain Health (Richmond, VA)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... in examining patterns of health care needs, decisions, lifestyle choices, and utilization of resources that affect their health. + Advocates, educates and coaches… more
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