Top 14 Utilization review nurse Jobs in Manassas 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
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
Special Operations Case / Nurse Case Manager Part-Time (National Capitol Region)
KBR —Alexandria, VA
- $49.31 - $54.64 an hour
- Part-time
- Nursing
- RN License
- Military
- AD&D insurance
- Disability insurance
Nurse Case Manager
Battelle —Arlington, VA
- Full-time
- Hybrid work
- Nursing
- RN License
- BLS Certification
- Wellness program
- Health insurance
Field RN Case Manager
MedStar Health —Washington, DC
- $89,065 - $162,801 a year
- Full-time
- Nursing
- Management
- RN License
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
12d
ADON - RN
Greenspring Village by Erickson Senior Living —Springfield, VA
- $115,000 - $130,000 a year
- 18 years or older
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Hospice Clinical Team Manager (RN Required)
VITAS Healthcare —Fairfax, VA
- Full-time
- Nursing
- RN License
- Mid-level
- Disability insurance
- Health insurance
Quick Apply

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utilization review nurse jobs near manassas va

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

utilization review nurse jobs in manassas va

Trainer Clinical Operations MedStar Family Choice DC

Registered Nurse (RN) Outpatient Behavioral Health

Special Operations Case / Nurse Case Manager Part-Time (National Capitol Region)

Nurse Case Manager

Field RN Case Manager

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

ADON - RN

Hospice Clinical Team Manager (RN Required)

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