Top 145 Rn Utilization Management Jobs in Fairfax, VA

Trainer Clinical Operations MedStar Family Choice DC
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Background check
- Nursing
- RN License
Quick Apply
LTSS Service Coordinator-RN Clinician
Elevance Health —Springfield, VA
- $41.84 - $62.76 an hour
- Full-time
- Nursing
- RN License
- Experience working with individuals with disabilities
- Employee stock purchase plan
- Paid holidays
Utilization Review Clinician - Behavioral Health
Centene —Washington, DC
- $27.02 - $48.55 an hour
- Weekends as needed
- Remote
- LMFT
- Nursing
- Addiction Medicine
- Paid holidays
- Health insurance
4d
Clinical Reviewer DC
Comagine Health —Washington, DC
- $93,000 - $104,000 a year
- Full-time
- Hybrid work
- RN License
- Writing skills
- Mid-level
- Paid parental leave
- Health insurance
Quick Apply
RN Supervisor, Appeals, Managed Care, UM
Centene —Washington, DC
- $75,300 - $135,400 a year
- Full-time
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
3d
Registered Nurse (RN) Outpatient Behavioral Health
Inova Health System —Sterling, VA
- 8 hour shift
- Hybrid work
- Nursing
- RN License
- Computer literacy
- Wellness program
- Paid parental leave
Travel RN - Case Management/Utilization Review - Case Management
American Traveler —Arlington, VA
- $2,917 a week
- 8 hour shift
- Acute care
- Nursing
- RN License
Quick Apply
Remote Triage Nurse
GPW Health Center Inc —Woodbridge, VA
- $25.75 - $32.62 an hour
- Full-time
- Remote
- Bilingual
- Nursing
- RN License
- Health savings account
- Paid holidays
Quick Apply
Quality Assurance and Utilization Review Manager
ASPEN OF DC INC —Washington, DC
- $33.65 an hour
- Nursing
- Microsoft Excel
- RN License
Quick Apply
7d
Registered Nurse (RN) Unit Supervisor CV Neuro ICU - Nights
Inova Health —Alexandria, VA
- $46.00 - $76.25 an hour
- Full-time
- Nursing
- Patient monitoring
- RN License
- Health insurance
- 401(k)
Quick Apply
3d
VP, ASC Operations
Prism Vision Group —Chevy Chase, MD
- $175,000 - $275,000 a year
- Up to 50% travel
- RN License
- Surgery
Director of Nursing (RN) Operating Room, Abdominal Transplant, Robotics and General Surgery
MedStar Health —Washington, DC
- $120,702 - $238,222 a year
- Full-time
- Nursing
- Microsoft Excel
- Surgery
Director of Nursing (RN) Operating Room - Abdominal Transplant, Robotics, Urology, General and Pediatrics
MedStar Health —Washington, DC
- $120,702 - $238,222 a year
- Full-time
- Nursing
- Surgery
- RN License
- Free parking
- Relocation assistance
RN In Hospital Transition of Care Case Manager
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Microsoft Excel
- Psychiatry
Quick Apply
Nursing Director (RN) Neurosciences ICU
MedStar Health —Washington, DC
- $120,702 - $238,222 a year
- Full-time
- Nursing
- RN License
- 5 years
Quick Apply
Clinical Administrator (RN)
MedStar Health —Washington, DC
- $99,931 - $152,280 a year
- Weekends as needed
- Nursing
- Microsoft Excel
- RN License
Branch Manager - Home Health Agency
Five Star Home Health Care —Chantilly, VA
- $120,000 - $140,000 a year
- Full-time
- Background check
- RN License
- HIPAA
- Mileage reimbursement
- Health savings account
Quick Apply
11d
RN Assistant Director of Nursing Emergency Department
MedStar Health —Clinton, MD
- $100,588 - $190,340 a year
- Full-time
- Background check
- Nursing
- Microsoft Excel
Quick Apply
RN In Hospital Transiton of Care Case Manager
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Background check
- Nursing
- Microsoft Excel
Quick Apply
Nursing Director (RN) Surgical Cardiovasular ICU
MedStar Health —Washington, DC
- $120,702 - $238,222 a year
- Full-time
- Nursing
- Surgery
- RN License
Quick Apply
3d

I want to receive the latest job alert for Rn Utilization Management in Fairfax, VA

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

Rn Utilization Management jobs near Fairfax, VA

Registered Nurse Case Manager jobs in Washington, DC

Registered Nurse Icu jobs in Washington, DC

Vice President Of Operations jobs in Chevy Chase, MD

Clinic Administrator jobs in Washington, DC

Travel Nurse jobs in Arlington, VA

Operations Associate jobs in Washington, DC

Registered Nurse Emergency Room jobs in Clinton, MD

Behavioral Health Counselor jobs in Washington, DC

Registered Nurse Case Manager jobs in Boston, MA

Registered Nurse jobs in Chesterfield, VA

Registered Nurse Case Manager jobs in Valdosta, GA

Registered Nurse Case Manager jobs in Bay City, MI

Rn Case Manager jobs in Dallas, TX

Nurse Practitioner jobs in Omaha, NE

Registered Nurse Case Manager jobs in Troy, MI

Registered Dietitian jobs in El Paso, TX

Icu Rn jobs in Las Vegas, NV

Nurse Practitioner jobs in Farmington Hills, MI

Rn Icu Prn jobs in Atlanta, GA

Registered Nurse jobs in Florence, SC

Trainer Clinical Operations MedStar Family Choice DC

MedStar Health -
Washington, DC

Quick Apply

Job Details

Full-time
$89,065 - $162,801 a year

Qualifications

Computer operation
Utilization review
RN License
Clinical case management
Clinical staff training
Bachelor's degree
Data entry
Bachelor's degree in nursing
Healthcare software applications

Full Job Description

About this Job: General Summary of Position
The trainer Clinical Operations MFC DC is a critical role that ensures the success of our newly hired RN Case Managers Case Manager Social Workers and other members of the Case Management / Clinical Operations staff. This associate will be responsible for the onboarding and ongoing training of our staff using a standard curriculum that adheres to state and other regulatory requirements. Working with Case Management Leadership this trainer will develop and maintain the curriculum for the Case Management / Clinical Operations department. Associate training will be conducted in person and virtual. The Trainer will have impact across MFC DC and Maryland health plan. The trainer will utilize performance data to determine training effectiveness and areas for improvement and share summary of findings with clinical leaders and Quality Improvement Committee (QIC). The trainer will maintain current knowledge about NCQA contract requirements healthcare / industry trends District regulations and other compliance standards.The trainer will assist with audits of staff documentation and their adherence to department processes and policies.

Primary Duties and Responsibilities

Demonstrates behavior consistent with MedStar Health mission vision goals objectives and patient care philosophy.
Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
Maintains current knowledge of MedStar Family Choice benefits and services available for enrollees.
Develops and maintains a curriculum workflow and processes for each role in Clinical Operations and ensure staff adhere to organizational standards and best practices.
Develops and maintains orientation and training schedule.
Offers personalized guidance and support to clinical operations team to improve performance and skill building.
Conducts ad hoc training to support staff with identified challenges with adhering to workflows and processes.
Conducts assessments to identify gaps in knowledge or skills among staff and provide written feedback to the clinical leaders.
Develops and leads quality improvement initiatives to enhance staff performance and clinical outcomes.
Develops and utilizes reports to share data on training activities participant feedback and performance improvements strategies then share with clinical leaders.
Monitors staff compliance with annual and ad hoc mandatory trainings.
Organizes and maintains a repository that houses training materials schedules etc.
Maintains current knowledge about NCQA contract requirements healthcare / industry trends District regulations and other compliance standards
Assists with audits of staff documentation and their adherence to department processes and policies.
Demonstrates proficiency with all MedStar Family Choice software systems that support the clinical operation.
Participates in evaluating and updating of the software systems to improve efficiencies and productivity.
Participates and contribute to meetings (staff meetings committee meetings etc.).
Uses performance data to determine training effectiveness and areas for improvement and shares summary of findings with clinical leaders and Quality Improvement Committee (QIC).

Minimal Qualifications
Education

Bachelor's degree in Nursing required

Experience

1-2 years Case Management and utilization review experience required and
1-2 years Training experience required and
3-4 years diverse clinical experience required

Licenses and Certifications

RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the District of Columbia and Maryland Upon Hire required

Knowledge Skills and Abilities

Skilled in planning executing and evaluating educational gaps and developing performance improvement initiatives
Possess exceptional interpersonal and communication skills
Knowledge of current trends in healthcare delivery and Case Management / utilization review criteria
Ability to use computer to enter and retrieve data.
Ability to create edit and analyze (Word Excel and PowerPoint) preferred
Demonstrate proficiency with all MedStar Family Choice software systems that support the clinical operation.
Be skilled in planning executing and evaluating educational gaps and developing performance improvement initiatives
Possess exceptional interpersonal and communication skills.

This position has a hiring range of : USD $89,065.00 - USD $162,801.00 /Yr.

Work Location: In person

Quick Apply

Refine Your Search

Rn Utilization Management jobs in Fairfax, VA

Trainer Clinical Operations MedStar Family Choice DC

LTSS Service Coordinator-RN Clinician

Utilization Review Clinician - Behavioral Health

Clinical Reviewer DC

RN Supervisor, Appeals, Managed Care, UM

Registered Nurse (RN) Outpatient Behavioral Health

Travel RN - Case Management/Utilization Review - Case Management

Remote Triage Nurse

Quality Assurance and Utilization Review Manager

Registered Nurse (RN) Unit Supervisor CV Neuro ICU - Nights

VP, ASC Operations

Director of Nursing (RN) Operating Room, Abdominal Transplant, Robotics and General Surgery

Director of Nursing (RN) Operating Room - Abdominal Transplant, Robotics, Urology, General and Pediatrics

RN In Hospital Transition of Care Case Manager

Nursing Director (RN) Neurosciences ICU

Clinical Administrator (RN)

Branch Manager - Home Health Agency

RN Assistant Director of Nursing Emergency Department

RN In Hospital Transiton of Care Case Manager

Nursing Director (RN) Surgical Cardiovasular ICU

I want to receive the latest job alert for Rn Utilization Management in Fairfax, VA

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected