Case manager • hampton va
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
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
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
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
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
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
Proudly supported by Marquis Health Consulting Services.Passion, Respect, and Excellence.Unit Manager oversees nursing operations on an assigned unit and ensures residents receive comprehensive, pe... Show more
Job Title: Community Outreach Case Manager Region: VA Program: SSG Fox Suicide Prevention (Behavioral Health) ... Show more
The Store Manager is responsible for overseeing all aspects of Retail, Grocery and Warehouse operations, including financial performance, compliance, inventory management, customer service, and tea... Show more
Looking for a leader to become the foundation of our Tropical Smoothie Cafe family in Hampton with potential to grow into a bigger role.Qualifications Ability to train and coach crew members a... Show more
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
Exciting Career Opportunity: Community Manager at Lexington Commons in Newport News, VA!Thalhimer is excited to offer a unique career opportunity with our Thalhimer Multifamily team.We are actively... Show more
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
Special Operations Case Manager / Nurse Case Manager (Hampton Roads,VA).THIS POSITION OFFERS RELOCATION.Special Operations Nurse Case Manager.Department of Defense (DOD) beneficiaries.Essential Dut... Show more
I don't know if my timing is right or not, but I am reaching out to you regarding a.Most people know that 7-Eleven is everywhere in the US and wouldn’t be surprised that we have nearly 8,800 7-Elev... Show more
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
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
Our WW Operations network delivers millions of packages and smiles to Amazon customers every day.We are looking for motivated, customer-focused individuals who want to join our team as an Area Mana... Show more
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
Flynn Hut joined the Pizza Hut system in 2021.In 2023, we expanded internationally acquiring Pizza Hut’s master franchisee in Australia with 260+ units.Today we are the largest Pizza Hut franchisee... Show more
The average salary range is between $ 45,000 and $ 82,275 year , with the average salary hovering around $ 51,750 year .
The average salary range is between $ 38,723 and $ 88,117 year , with the average salary hovering around $ 49,715 year .
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.
