Top 1217 Utilization Manager Job Jobs in Merrifield, VA

Registered Nurse Case Manager
Inova Health System —Falls Church, VA
- Full-time
- Remote
- Nursing
- RN License
- BLS Certification
- Wellness program
- Paid parental leave
18h
Unit Manager
Potomac Falls & Rehab Center —Sterling, VA
- $87,000 - $105,000 a year
- Full-time
- Background check
- Patient monitoring
- RN License
- Continuing education credits
- Health savings account
Quick Apply
Hybrid Clinical Supervisor/BCBA - Lanham - $10,000 sign on bonus
Helping Hands Family —Lanham, MD
- $100,000 - $120,000 a year
- Hybrid work
- Background check
- Clinic
- Supervising experience
- Continuing education credits
- Health insurance
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Clinical Supervisor/BCBA - Leesburg, VA
Helping Hands Family —Leesburg, VA
- $100,000 - $110,000 a year
- Background check
- Clinic
- Supervising experience
- Continuing education credits
- Health insurance
Quick Apply
Clinical Care Manager
Senior Community Care of Maryland —Lanham, MD
- $101,000 - $134,000 a year
- Weekends as needed
- Nursing
- RN License
- Mid-level
- Wellness program
- Paid holidays
Quick Apply
12d
Control Desk Coordinator RN PM Shift
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Surgery
- RN License
RN - Registered Nurse (Awake Overnight)
YOUTH FOR TOMORROW NEW LIFE CENTER INC —Bristow, VA
- $100,000 - $105,000 a year
- Weekends as needed
- Spanish
- CPR Certification
- Nursing
- Paid holidays
- Disability insurance
11d
Clinical Supervisor - Suitland - $10,000 sign on bonus
Helping Hands Family —Suitland, MD
- $100,000 - $120,000 a year
- Background check
- Clinic
- Supervising experience
- Continuing education credits
- Health insurance
Quick Apply
Occupational Therapist
Reliant Rehabilitation —Woodbridge, VA
- $43 - $46 an hour
- Full-time
- Skilled nursing facility
- Computer literacy
- English
- Loan repayment program
- Health insurance
CDL-A Regional Company Truck Driver Jobs – NE Routes
EPES Transport System —Washington, DC
- $1,500 - $1,650 a week
- Full-time
- No touch freight
- CDL A
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Program Analyst
RWD Consulting, LLC —Bethesda, MD
- $75,000 - $90,000 a year
- Full-time
- Computer Science
- English
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
4d
Mental Health Travel Therapist
Sandstone Care —North Bethesda, MD
- $80,000 - $90,000 a year
- Weekends as needed
- Background check
- LMFT
- CPR Certification
- Paid holidays
- Health insurance
Quick Apply
CDL-A Regional Company Truck Driver Jobs – NE Routes
EPES Transport System —Falls Church, VA
- $1,500 - $1,650 a week
- Full-time
- No touch freight
- CDL A
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Mental Health Travel Therapist
Sandstone Care —Alexandria, VA
- $80,000 - $90,000 a year
- Weekends as needed
- Background check
- LMFT
- CPR Certification
- Paid holidays
- Health insurance
Quick Apply
Case Management Program Manager (Registered Nurse or Social Worker)
Inova Health System —Falls Church, VA
- $48.29 - $78.71 an hour
- Full-time
- Nursing
- RN License
- 5 years
- Wellness program
- Paid parental leave
Quick Apply
Manager, Nursing
Connections Health Solutions —Leesburg, VA
- Full-time
- Background check
- Nursing
- RN License
- Paid parental leave
- Health savings account
Quick Apply
Case Manager (Supports Planner)
Service Coordination, Inc —Bethesda, MD
- $64,395 - $79,861 a year
- Nursing
- RN License
- Experience working with individuals with disabilities
- Paid training
- 403(b) matching
Quick Apply
Case Manager (Service Coordinator)
Service Coordination, Inc —Gaithersburg, MD
- $64,395 - $79,861 a year
- Pass drug screening
- HIPAA
- Research
- Paid training
- 403(b) matching
Quick Apply
7d
Field RN Case Manager
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Management
- RN License
12d
HVAC Install Manager
AllTech Services —Sterling, VA
- $100,000 - $120,000 a year
- Clean driving record
- Residential
- Driver's License
- Paid training
- Paid holidays
Quick Apply

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Registered Nurse Case Manager

Inova Health System -
Falls Church, VA

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Job Details

Full-time
18 hours ago

Benefits

Wellness program
Paid parental leave
Health insurance
Dental insurance
Paid time off
Parental leave
Vision insurance
Loan assistance

Qualifications

BLS Certification

Full Job Description

The Inova Center for Personalized Health (ICPH) is seeking an experienced RN Case Manager to join our growing team. This is a fully remote position after the completion of onsite training at ICPH.

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.

The RN Case Manager 1 provides discharge planning and continuity of care for assigned patients in acute and post-acute settings. Provides coordination of services and acts as key liaison between patients, families and interdisciplinary healthcare members. Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities. Responsible for the timely regulatory compliance and facilitation of precertification and payer authorization processes when indicated. Actively participates in clinical performance improvement activities.

Featured Benefits:

Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
Retirement: Inova matches the first 5% of eligible contributions – starting on your first day.
Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.

Registered Nurse (RN) Case Manager I Job Responsibilities:

Collects delay and other data for specific performance and/or outcome indicators. Assists in the collection and reporting of resource and financial indicators including acute and post-acute case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals. Collects, analyzes and addresses variances from plans of care and care paths with physicians and/or other members of the healthcare team. Uses concurrent variance data to drive practice changes and positively impact outcomes. Documents key clinical path variances and outcomes which relate to areas of direct responsibility (e.g. discharge planning, chronic disease planning).
Uses pathway data in collaboration with other disciplines to ensure effective patient management concurrently. Ensures safe care to patients by adhering to policies, procedures and standards within budgetary specifications including time management, supply management, productivity and accuracy of practice. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency. Supports department based goals which contribute to the success of the organization.
Provides discharge planning and continuity of care for assigned patients in the acute and post-acute setting. Initiates and facilitates referrals to clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment and supplies as indicated. Collaborates with the interdisciplinary healthcare team, patients and families in the assessment and coordination of discharge planning needs, delivery of post-discharge planning needs, delivery of post-discharge services and transition of patients from hospitals to the discharge setting as well as ongoing care in the community. Documents relevant discharge planning information in medical records according to department standards and/or care management plans.
Collaborates/communicates with internal and external case managers. Understands pre-acute and post-acute resources. Provides coordination of services and acts as a key Liaison between patients, families and the interdisciplinary healthcare team members. Work closely with members of patients' healthcare teams to manage and coordinate all areas of patients' care. Works holistically to ensure that healthcare plans and discharge plans meet the physical, social and emotional needs of patients.
Provides educational resources and/or referrals to patients and patients' families to address identified needs such as social or financial. Acts as an advocate for patients to resolve barriers to care progression. Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities.
Discusses payer criteria and issues on a case by case basis with clinical staff and follows-up to resolve problems with payers as needed. Applies approved clinical criteria to monitor appropriateness of admissions, continued stays or post-acute setting appropriateness and documents findings based on department standards.
Identifies at risk populations by using approved screening tools and following established reporting procedures. Monitors LOS and ancillary resource use, depending on inpatient stay or outpatient program criteria, on an ongoing basis and takes actions to achieve continuous improvement efficiencies in both areas. Refers cases and issues appropriately to resolve barriers to care progression.
Participates in the assessment of patients' clinical and psychosocial needs through review of patient information, personal contact with patients/families and interdisciplinary healthcare team members. Communicates routinely with patients, families, interdisciplinary healthcare team members and other appropriate parties with regard to the status of patients' care plans and progress toward treatment goals, identification of concerns and/or problems, problem solving and assisting with conflict resolution when necessary. Works with the multidisciplinary team to address/resolve system problems impeding diagnostic or treatment progress. Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge. Ensures that all elements critical to patients' care plans have been communicated to the patients/families and members of the healthcare team.

Minimum Qualifications:

Certification: Basic Life Support (American Heart Association)
Licensure: Licensed or eligible for licensure in the Commonwealth of Virginia as a Registered Nurse or an active multi-state Registered Nurse license
Experience: 1 year of case management and/or clinical care experience
Education: Bachelor's Degree Nursing or Associate's Degree. If RN has an Associate's Degree, within 2 years of date of hire, they must meet with their nurse leader and conduct the following: 1.) Identify which accredited school they plan to attend 2.) Provide a written plan with anticipated BSN completion date 3.) Submit a review of transcripts from the school indicating the required pre-requisites and timeline for taking the courses 4.) Complete BSN within 5 years of start date.

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Refine Your Search

Utilization Manager Job jobs in Merrifield, VA

Registered Nurse Case Manager

Unit Manager

Hybrid Clinical Supervisor/BCBA - Lanham - $10,000 sign on bonus

Clinical Supervisor/BCBA - Leesburg, VA

Clinical Care Manager

Control Desk Coordinator RN PM Shift

RN - Registered Nurse (Awake Overnight)

Clinical Supervisor - Suitland - $10,000 sign on bonus

Occupational Therapist

CDL-A Regional Company Truck Driver Jobs – NE Routes

Program Analyst

Mental Health Travel Therapist

CDL-A Regional Company Truck Driver Jobs – NE Routes

Mental Health Travel Therapist

Case Management Program Manager (Registered Nurse or Social Worker)

Manager, Nursing

Case Manager (Supports Planner)

Case Manager (Service Coordinator)

Field RN Case Manager

HVAC Install Manager

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