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Case manager Jobs in Hampton, VA

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Case manager • hampton va

Last updated: 3 hours ago

Remote Utilisation Management / Case Management leader (RN/Physician-advisor) - AI Trainer

MercorNewport News, Virginia, US
Remote
Full-time

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced Utilisation Management and Case Management leaders — including ... Show more

Manager

Dunkin'Newport News, VA, United States
Full-time

As a Dunkin' franchisee, we are committed to our employees as much as we are committed to our customers.We value hardworking and enthusiastic employees and we make it a priority to ensure their suc... Show more

HACCP Program Manager / Project Manager

I-2-I Solutions, Inc.Asheville, Durham, Fayetteville, Hampton, Richmond, Salem, Salisbury, VA, US
Full-time
Quick Apply

Position Summary The HACCP Program Manager is the contractor's designated key person for the VISN 6 Water Management / Legionella Testing contract.The solicitation requires this individual to hold ... Show more

General Manager

LTD Hospitality GroupNewport News, VA, US
Full-time

LTD Hospitality Group is seeking highly motivated, strategic leaders with expertise in effective and efficient hotel operations.Our ideal candidates should exude a passion for the hospitality indus... Show more

RN Case Manager

VHS HospiceNewport News, VA
Full-time

VHS Hospice as a Hospice RN Case Manager.Proudly supported by Marquis Health Consulting Services  .Full-time, part-time, and PRN opportunities available!.Locations include: Hampton, Newport Ne... Show more

trainee - Case Manager

Peninsula Alcohol Safety Action ProNewport News, VA, US
$38,000.00 yearly
Full-time

NOTE:  This Is Not a State Position.This position will be responsible for conducting intakes, assisting clients, scheduling intervention classes, case reviews, and appointments, requesting status u... Show more

Personal Injury Case Manager

The Smith Law CenterHampton, VA, US
$48,000.00 yearly
Full-time

The Smith Law Center has fought for the seriously injured since 1949.For more than 75 years, we’ve stood with individuals and families after life-changing accidents, securing justice in traumatic b... Show more

Youth Independent Living - Case Manager

Intercept HealthHampton, VA, USA
$21.00 hourly
Full-time
Quick Apply

Life Skills Coach/Case Manager - Young Adult Independent Living ProgramNow offering a $2,000 sign on bonus!$21-$23/hourIntercept Health is a family-owned agency serving various mental and behaviora... Show more

General Manager

McDonald'sNewport News, VA, United States
Full-time

McDonald's Management Opportunity.Smith Enterprises McDonald's is seeking experienced self-directed managers capable of building and leading a progressive and diversified team that not only meets b... Show more

Project Manager

Clancy & Theys Construction CompanyNewport News, VA, United States
Full-time

At Clancy & Theys Construction Company, we build more than exceptional projects we build lasting relationships, strong teams, and thriving communities, guided by our core values of Safety, Steward... Show more

Clinical Case Manager

Benevolent Family ServicesHampton, VA, United States
Full-time

At Benevolent Family Services, our mission is to provide comprehensive, compassionate, and dedicated support to individuals facing mental health challenges.We are committed to empowering lasting, p... Show more

Service Facilitator/Case Manager

Inspired Life ServicesHampton, Virginia, United States
$25.00 hourly
Full-time
Quick Apply

Medicaid Waiver Service Facilitator/Case Manager (Independent Contractor – 1099) - Hampton Roads, Tidewater.The Service Facilitator/Case Manager (SF) is responsible for coordinating and monitoring ... Show more

Special Operations Case Manager / Nurse Case Manager (Hampton Roads, VA)

KBRHampton, Virginia
Full-time

Special Operations Case Manager / Nurse Case Manager (Hampton Roads, VA).THIS POSITION OFFERS RELOCATION.KBR is a company of innovators, thinkers, creators, explorers, volunteers, and dreamers; but... Show more

Manager

Captain D'sNewport News, VA, US
$39,000.00 yearly
Full-time

We are looking for experienced and skilled restaurant managers with remarkable skills, who will run a store effectively and with attention to detail.As a Captain D's Manager, your primary role is t... Show more

Case Manager

Hampton-Newport News Community Services BoardHampton, VA, USA
Full-time
Quick Apply

Child & Adolescent Intensive Care Coordination Case ManagerAnnual Salary - $53,569Work Schedule: Monday - Friday 8:30 am - 5:00 pm (Some on-call responsibilities)Case Management is a vital part of ... Show more

RN Case Manager

VHS Home Health CareNewport News, Virginia
Full-time
Quick Apply

VHS Home Health as an RN Case Manager.Proudly supported by Marquis Health Consulting Services.Full-time opportunities available!.Hampton, Newport News, Williamsburg, Yorktown, Norfolk, and Virginia... Show more

 • New!

District Manager

Monro, Inc.Hampton, VA, United States
$90,000.00 yearly
Full-time

We are the country's top company-owned automotive repair chain, and our success is driven by employing great people who commit every day to putting our guests first--selling them only what they nee... Show more

SF Case Manager Hampton

Moms In MotionHampton, VA, US
Full-time

Service Facilitator (SF) Case Manager.Daily local travel to client homes.At Moms In Motion, our Service Facilitators are everyday heroes.You’ll spend your days connecting with families, helping the... Show more

Social Services / Case Manager (Child & Family Support Exp)

22nd Century Technologies, Inc. (TSCTI)Newport News, VA, US
Full-time

Job Title: Social Services / Case Manager (Child & Family Support Exp) Duration: 6+ Months Payrate: $ 23.Per Hour On W2 Without Benefits Description: Bachelor's degree in Social Work, Human Service... Show more

 • Promoted

Store Manager

Panda Restaurant GroupHampton, VA, US
$27.00 hourly
Full-time

Are You Craving A Career With An Industry Leader?.Panda Express is searching for experienced leaders to join our store management team.Panda is 100% committed to the professional and personal devel... Show more

Remote Utilisation Management / Case Management leader (RN/Physician-advisor) - AI Trainer

Remote Utilisation Management / Case Management leader (RN/Physician-advisor) - AI Trainer

MercorNewport News, Virginia, US
30+ days ago
Job type
  • Full-time
  • Remote
Job description
Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems. We are seeking experienced Utilisation Management and Case Management leaders — including RN UM directors, case management managers, and physician advisors — to evaluate AI tools designed to enhance clinical review, medical-necessity determination, and care-coordination workflows. Your clinical and operational expertise will directly shape AI systems that improve utilisation performance, reduce unnecessary care, and support value-based care objectives. **Responsibilities** - Lead utilisation management and/or case management operations, including concurrent review, retrospective review, discharge planning, and care coordination. - Evaluate AI-generated medical necessity determinations, clinical review outputs, and UM decision-support recommendations for accuracy and clinical appropriateness. - Conduct and oversee clinical reviews against InterQual, MCG, or Milliman care guidelines to support admission, continued stay, and level-of-care determinations. - Manage the physician advisor program to support complex UM cases, peer-to-peer review requests, and denial appeals. - Coordinate with clinical teams, payers, and post-acute providers to facilitate appropriate care transitions and discharge planning. - Monitor UM/CM KPIs, including avoidable days, denial rates, observation vs. inpatient conversion rates, and readmission rates. - Ensure compliance with CMS Conditions of Participation, Two-Midnight Rule, and payer-specific UM requirements. - Collaborate with revenue cycle, compliance, and clinical leadership to align UM performance with financial and quality objectives. - Annotate AI outputs and provide structured clinical feedback to support AI training datasets. **Requirements** - 5+ years of experience in utilisation management, case management, or clinical review, with at least 2 years in a leadership role. - Active clinical licensure (RN required; physician advisor/MD preferred) with strong medical necessity review expertise. - Deep knowledge of InterQual, MCG, or Milliman clinical review criteria. - Expertise in CMS Two-Midnight Rule, observation status regulations, and inpatient criteria. - Experience managing physician advisor programs and peer-to-peer review processes with payers. - Exceptional written and verbal English communication skills. - High attention to detail with the ability to critically evaluate clinical documentation and AI-generated UM outputs. **Preferred Qualifications** - CPUR (Certified Professional in Utilisation Review), ACM (Accredited Case Manager), or CCM (Certified Case Manager) credential. - MD or DO with UM/physician advisor experience preferred for physician advisor roles. - Experience with UM software platforms (Allscripts, Utilisation Management software, or equivalent). - Familiarity with AI tools and comfort evaluating AI-generated clinical review content. - Background in health system, ACO, or value-based care organisation UM programs. **Why Join?** - Contribute to the development of frontier AI systems in healthcare. - Collaborate with a world-class AI research organisation. - Gain exposure to cutting-edge AI workflows in utilisation management and clinical decision-support. - Opportunity to work on high-impact projects shaping the future of healthcare AI.