Utilization Management Nurse Jobs in Virginia
TravelNurseSource
$2500 - $2595
Falls Church, VA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
Sunrise Senior Living
Fort Belvoir, VA
The unique responsibilities for this role include but are not limited to the essential functions listed as follows: Clinical Care Delivery OperationsDirects, supervises the management of the team members in the skilled nursing center. Quality Assurance and Regulatory ComplianceStrives for excellent quality care and service delivery as measured in the Five Star Rating and Quality Measures and institutes with follow up measures on corrective actions in a timely manner.
Henrico Doctors' Hospital
Richmond, VA
Envisioned, founded and supported by a group of independent physicians looking to provide high-quality care in an accessible community setting, Henrico Doctors' proudly remains committed to providing patients with the best care possible. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Encompass Health Rehabilitation Hospital of Northern Virginia
Herndon, VA
Join us in this journey of care, compassion, and leadership as we work together to make a difference where it matters most, serving as a key member of our leadership team overseeing the day-to-day operations and management of our Case Management department. Oversee the interdisciplinary plan of care and the discharge planning process to ensure the effectiveness and appropriateness of services with a central focus on census management, patient care outcomes, and key care indicators.
The Laurels of University Park
Richmond, VA
Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator. See Ciena Healthcare Management Privacy Policy at https://apploi.com/privacy_policy/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
Yale New Haven Health
Prospect, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator . Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process.
Yale New Haven Health
Woodbridge, VA
Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION: Graduation from an accredited school of nursing. Additional Information Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION: Graduation from an accredited school of nursing. Additional Information Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION: Graduation from an accredited school of nursing. Additional Information Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient # Demonstrates Skill And Knowledge In Neuro Assessment # Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient # Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures # Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace # Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Graduation from an accredited school of nursing. Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION: Graduation from an accredited school of nursing. Additional Information Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION Graduate Of An Accredited School Of Nursing; BSN Preferred. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information Med/Surg RN experience required.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION Graduate Of An Accredited School Of Nursing; BSN Preferred. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information Med/Surg RN experience required.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION Graduate Of An Accredited School Of Nursing; BSN Preferred. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information Med/Surg RN experience required.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION: Graduation from an accredited school of nursing. Additional Information Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION: Graduation from an accredited school of nursing. Additional Information Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
The Laurels of Bon Air
Richmond, VA
Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator . Discusses resident care needs with care givers, including physician, nursing, social services, therapy, dietary, and activity staff.
Monogram Health
Richmond, VA
Reporting to the Region President, the Market Physician Executive (MPE) is a key clinical leader within Monogram Health who contributes to the development and oversight of clinical strategies, policies, programs, processes, protocols, guidelines, and operations that drive improved patient health outcomes within the market. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
TravelNurseSource
$2613.33
Falls Church, VA
License: BSN required Certifications: BLS required Must-Have: - Minimum 2 years of direct supervisor/manager experience - Minimum 3 years in case management or relevant nursing experience Description: The Manager of Case Management participates in clinical performance improvement activities. It is crucial to ensure referrals are initiated to the appropriate next level of care, such as acute care, home health care, hospice, skilled nursing facilities, long-term acute care, clinics, and transitional care management, in a timely manner.
TravelNurseSource
$2447 - $2719
Northern Virginia, VA
Works in collaborative practice with Physicians and Physician extenders to actively support the delivery of cost effective, outcome oriented, quality care in the appropriate health care setting to meet patient specific, age and cultural needs. Works in collaborative practice with the physician and other members of the health care team to meet patient specific and age-related needs linking cost and quality to patient care.
The Laurels of University Park
Richmond, VA
Is prepared to conduct PPS meetings maintaining MDS assessments per Medicare schedule and maintains PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management Coordinator . The Care Management Nurse, MDS Nurse works the RAI process and conducts assessments and care plan coordination for those residents assigned.
VCU Health System
Richmond, VA
In collaboration with other ambulatory leadership directs the acquisition and allocation of human, material, and financial resources to ensure utilization in an appropriate and cost-effective manner. Management of a building or multiple smaller locations to include facility management, local vendor contracts, space management, staffing plans, supply mgmt.
Yale New Haven Health
Prospect, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION Graduate Of An Accredited School Of Nursing; BSN Preferred. This specialized department caters to both medical oncology patients, who receive systemic therapies like chemotherapy, immunotherapy, and targeted therapies, and surgical oncology patients, who are in various stages of their surgical journey, including pre-operative evaluation, post-operative care, and follow-up.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION: Graduation from an accredited school of nursing. Additional Information Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Yale New Haven Health
Prospect, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator . Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process.
Yale New Haven Health
Woodbridge, VA
Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION Graduate Of An Accredited School Of Nursing; BSN Preferred. EXPERIENCE N/A LICENSURE Valid State Of Connecticut Registered Nurse License SPECIAL SKILLS BLS Required Additional Information Med/Surg RN experience required.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator . Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process.
Yale New Haven Health
Woodbridge, VA
Demonstrates Competency In The Care Of The Neuro Patient Demonstrates Skill And Knowledge In Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding In Caring For A Trached Patient Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator Qualifications EDUCATION: Graduation from an accredited school of nursing. Additional Information Heart and Vascular Cardiac ICU (5-1 SP) The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure.
Kaiser Permanente
Springfield, VA
Minimum one (1) year of experience working directly with individuals who meet the Cardinal Care Priority Population criteria (Individuals with Substance Use Disorder, Youth with a mental health diagnosis, Individuals involved with Child Protective Services, foster care, and/or former foster youth). The nurse care manager is responsible for coordination of appropriate, cost-effective services that enhance a members quality of life, focus on a members optimal level of independence, and reduces inappropriate utilization of medical services.
ChenMed
$214700 - $306714
Richmond, VA
The Primary Care Physician (PCP) is a licensed/Board Certified/Board Eligible trained professional in internal or family medicine who plays a key role as part of the clinical operations team providing direct patient care and providing assessments primarily in the ambulatory health care center setting, or occasionally in acute care, nursing homes, skilled nursing facilities (SNF) and home settings depending on the nature of the assignment. Patient management includes the following: 1) writing admission, transfer and discharge orders; 2) ordering and interpreting appropriate laboratory and diagnostic studies: 3) ordering of appropriate medication and treatments; 4) referring patients for consultation when indicated i.e. dermatology, neurology, ophthalmology, endocrine, surgery, intensive care, infectious disease, hematology, psychiatry, social service, dietary, etc.
Humana
$71100 - $97800
Richmond, VA
The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.
Humana
$71100 - $97800
Richmond, VA
As a Utilization Management RN working on the OneHome/Home Solutions UM Team, you will have the opportunity to use your clinical knowledge, communication skills, and independent critical thinking skills to ensure value-based care for members who desire to heal at home. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.
Elevance Health
Richmond, VA
URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Humana
$65000 - $88600
Richmond, VA
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. + Must reside in the state of Kentucky or a county that is contiguous to Kentucky state border in Ohio, Indiana, Illinois, Missouri, Tennessee, Virginia, or West Virginia. + Bachelor’s degree in nursing OR a master's degree in a Human Services field with a professional individual or compact licensure in the state of Kentucky without disciplinary action.
Sharecare
Richmond, VA
The Disease Management Nurse is also responsible during their interactions with participants for identification of those who are at risk for increasing acuity, and for educating the participant about that risk and if necessary and with the participants permission contacting their Primary Care Provider according to the disease management program intervention guidelines. By providing health education and resources, reviewing the provider’s plan of care with the member to ensure understanding and adoption, and utilizing motivation interviewing and behavior change techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes.
Life Center of Galax
Galax, Virginia
United Therapeutics
$168000 - $220000
Richmond, VA
Serve as an educational resource deployed to help ensure that physicians, nurses and other allied healthcare professionals are educated on PAH disease state and identify educational gaps that exist in the PAH space (e.g disease progression, risk stratification, therapies, clinical considerations etc.) and work to increase awareness around those identified gaps. + Ability to work independently and efficiently with minimal oversight; experience using time management skills such as prioritizing/organizing and tracking details while meeting deadlines of multiple projects without varying completion dates while traveling.
Highmark Health
Richmond, VA
This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._.
Augusta Health
Fishersville, Virginia
Quick Stats for 2023 Licensed for 255 beds 124 Medical/Surgical 14 Intensive Care Unit 18 Labor and Delivery 4 Pediatric Non-traditional, Non-acute services 28 bed psychiatric unit 17 bed skilled nursing unit 8 bed rehab unit Largest local private employer Employees: 2,375+ Active Physicians: 225 APPs: 87 Volunteers: 290 Service Area: 200,000 AH Urgent Cares: 5 AH Practices: 49. Assess/Plan- Assess and develop individualized needs and plan of care:Initial and ongoing comprehensive assessments are complete and appropriate for patients age, special care needs, patient’s knowledge level, and psychosocial, emotional, physical, functional, environmental, and spiritual needs.
MarinHealth Medical Center
$66.03 - $99.04
Bon Air, CA
MarinHealth is already realizing the benefits of impressive growth and has consistently earned high praise and accolades, including being Named One of the Top 250 Hospitals Nationwide by Healthgrades, receiving a 5-star Ranking for Overall Hospital Quality from the Centers for Medicare and Medicaid Services, and being named the Best Hospital in San Francisco/Marin by Bay Area Parent, among others. The RN Case Manager, in collaboration with members of the healthcare team, leads the development and implementation of the interdisciplinary plan of care for patients, determining the appropriate level of care, supervising the provision of the discharge plan of care, and ensuring the effective quality and cost-efficient outcomes by performing concurrent and retrospective case review.
InnovAge
$38.8 - $50.48
Charlottesville, Virginia
Ensure that quality care is delivered by home care team to site participants via periodic participant/caregiver inquiry, intermittent review of care plan, and trending of data from various reports/supervisory visits in collaboration with the Home Care Manager. Regardless of past practices, all candidates/resumes submitted by search firms to InnovAge by any means without a valid written search agreement in place for that position will be deemed the property of InnovAge and no fee will be paid in the event such candidate is hired by InnovAge.
Evolent
$32 - $37
Richmond, VA
Tasks are performed within the RN/LVN/LPN scope of practice, under Medical Director direction, using independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.
All Medical Personnel
$2000 - $2100
Northern Virginia, VA
Works in collaborative practice with Physicians and Physician extenders to actively support the delivery of cost effective, outcome oriented, quality care in the appropriate health care setting to meet patient specific, age and cultural needs. Works in collaborative practice with the physician and other members of the health care team to meet patient specific and age-related needs linking cost and quality to patient care.
Akahi Associates/Kako'o Services, LLC
Portsmouth Naval Base, Virginia
With a corporate office in Honolulu, Hawaii and recruiting office in San Antonio, Texas we specialize in providing skilled, trained and highly successful healthcare workers, including RNs, CRNAs, Physicians, LPN/LVN, Licensed Social Workers, and many more. Graduate from an academic program, within the nursing specialty field of study that is accredited by a regional or national nursing accrediting agency recognized by the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE).
Humana
$71100 - $97800
Richmond, VA
Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is required. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.
Vera Whole Health
Richmond, VA
Ensure comprehensive care in alignment with the Vera medical home model, including collection of comprehensive health history, performing appropriate physical examinations, conducting diagnostic testing, and prescribing medications – all with the convenience of onsite lab and pharmacy. The Vera model is anchored by three core elements: high engagement, managed care, and organizational culture change, which combine to drive down utilization of costly services like ER, inpatient/outpatient visits, and transform the overall health of the organization.
Somatus, Inc.
McLean, Virginia
Virtually identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings. Facilitates continuum of patients’ care utilizing basic nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes.
Battelle Memorial Institute
Norfolk, VA
Possess oral and written communication skills to meaningfully interact with peers, outside agencies, vendors, providers, and Military Health System (MHS) stakeholders to exchange information, provide briefings, presentations, research, and metrics to demonstrate or advance effective, efficient case management practice, outcomes, and organizational/MHS value. + Collect, organize, record, and communicate data relevant to primary health assessments including a detailed medical history to develop time sensitive treatment plans which delineate the expected process of care delivery for selected case managed patients or populations.