• Clinical Registered Nurse

    Cognizant (Annapolis, MD)
    …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
    Cognizant (10/07/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse - Home…

    Humana (Annapolis, MD)
    …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
    Humana (09/12/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    Humana (Annapolis, MD)
    …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... Communities is good for the Soul. Join Us!** The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
    Humana (10/18/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse

    CVS Health (Annapolis, MD)
    …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team.… more
    CVS Health (10/21/25)
    - Save Job - Related Jobs - Block Source
  • Associate Manager, Clinical Health Services…

    CVS Health (Annapolis, MD)
    …non-compact states as needed. + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals ... of utilization management services for assigned area + Implements clinical policies & procedures in accordance with applicable regulatory and accreditation… more
    CVS Health (10/15/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager, Registered Nurse

    CVS Health (Annapolis, MD)
    …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
    CVS Health (10/15/25)
    - Save Job - Related Jobs - Block Source
  • SNF Utilization Management RN - Compact Rqd

    Humana (Annapolis, MD)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse (RN)** in the (appropriate state)… more
    Humana (09/12/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Clinician-…

    CVS Health (Annapolis, MD)
    …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... we do it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization more
    CVS Health (10/21/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Reviewer, Nurse -9am -6pm…

    Evolent (Annapolis, MD)
    …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
    Evolent (10/21/25)
    - Save Job - Related Jobs - Block Source
  • Consultant, Nurse Disability I

    Lincoln Financial (Annapolis, MD)
    …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible… more
    Lincoln Financial (10/10/25)
    - Save Job - Related Jobs - Block Source
  • QM Nurse Consultant

    CVS Health (Annapolis, MD)
    utilization to improve clinical care and outcomes. Required Qualifications: Registered Nurse (RN) required. Working knowledge of problem solving and ... of policies, procedures, and guidelines that focus on improving clinical quality and ensuring patient safety. Collaborates with cross-functional teams,… more
    CVS Health (10/21/25)
    - Save Job - Related Jobs - Block Source