• Registered Nurse

    Ascension Health (Baltimore, MD)
    …Provide health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
    Ascension Health (05/03/25)
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  • Registered Nurse

    Veterans Affairs, Veterans Health Administration (Baltimore, MD)
    …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... facilitates interdisciplinary team collaboration, from admission through discharge. He/she will review medical records and accurately document UM reviews in NUMI… more
    Veterans Affairs, Veterans Health Administration (05/16/25)
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  • Utilization Review Nurse (RN)…

    Ascension Health (Baltimore, MD)
    …salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes ... review programs and key performance indicators for all utilization review activities. + Interact with medical,...of staff **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date… more
    Ascension Health (03/26/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Annapolis, MD)
    …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
    Sharecare (05/10/25)
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  • Interim RN Utilization Review

    Ascension Health (Baltimore, MD)
    …job transfer date required. American Heart Association or American Red Cross accepted. + Registered Nurse obtained prior to hire date or job transfer date ... required. Education: + Required professional licensure/certification AND 3 years of experience and 1 year of cumulative leadership experience required. **Additional Preferences** \#ATP **Why Join Our Team** Ascension associates are key to our commitment of… more
    Ascension Health (04/24/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Baltimore, MD)
    …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
    Fresenius Medical Center (04/01/25)
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  • Clinical Reviewer, Nurse (Pain Mngt)

    Evolent (Annapolis, MD)
    …are applied appropriately. **Qualifications:** + Current, unrestricted state licensure as a Registered Nurse + Associate or Bachelors in Nursing (Must be ... , you will be a key member of the utilization management team. We can offer you a meaningful...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not...a Registered Nurse ) + Experience as an RN… more
    Evolent (05/16/25)
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  • Population Health Nurse (RN) Manager

    Ascension Health (Baltimore, MD)
    …and salary range at the time of the offer._ **Responsibilities** Manage assigned Registered Nurse (RN) case managers, related activities and workflow to ensure ... including but not limited to: Access Authorization and pre-certification, utilization review and denial management, CareCoordination, Collaborative treatment… more
    Ascension Health (05/06/25)
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  • Sr. Nurse Practitioner

    Johns Hopkins University (Baltimore, MD)
    …team while maintaining patient confidentiality. **Minimum Qualifications** + Master's Degree in Nursing; Registered Nurse license and Certified as a Nurse ... The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for… more
    Johns Hopkins University (05/16/25)
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  • Sr Nurse Practitioner

    Johns Hopkins University (Columbia, MD)
    …fluids with blood borne pathogens. **Minimum Qualifications** + Master's Degree in nursing. + Registered Nurse license and certified as a Nurse Practitioner ... The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for… more
    Johns Hopkins University (05/06/25)
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  • Nurse Practitioner

    Johns Hopkins University (Baltimore, MD)
    …fluids with blood borne pathogens. **Minimum Qualifications** + Master's Degree in Nursing. + Registered Nurse license and Certified as a Nurse Practitioner. ... support in response to emergency situations. + Prepare chart documentation for review and counter signature by the physician. + Determine differential diagnosis. +… more
    Johns Hopkins University (03/11/25)
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  • Consultant, Nurse Disability

    Lincoln Financial (Annapolis, MD)
    …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like… more
    Lincoln Financial (04/30/25)
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  • RN Hospice Case Manager (Facility-Based)

    Amergis (Columbia, MD)
    Salary: $54 / Hour The Registered Nurse - Hospice Case Manager is responsible for providing care, comfort and supportto terminally ill patients. The Registered ... the delivery of hospice patient carein various settings. The Registered Nurse demonstrates the abilityto make clinical...highest level of care. + Inform Team Leader of utilization of other team members, outside agencies, and community… more
    Amergis (05/14/25)
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  • Care Management Supervisor - (Hybrid)

    CareFirst (Baltimore, MD)
    …of care and manage health care costs. We are looking for an experienced Registered Nurse and people leader with UM/CM experience living within the greater ... required work experience. **Licenses/Certifications Upon Hire Required:** Health Services\RN - Registered Nurse Active State Licensure and/or Compact State… more
    CareFirst (04/17/25)
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  • Clinical Appeals Manager (Hybrid)

    CareFirst (Baltimore, MD)
    …required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure Upon ... with dynamic goals resulting in the full and fair review of appeals and grievances designed to achieve corporate...Manager Upon Hire Preferred or + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred **Experience:** 5 years'… more
    CareFirst (05/04/25)
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  • RN Clinical Manager

    Erickson Living (Parkville, MD)
    …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... (skilled nursing, long term care, assisted living or hospital) is required. + Current Registered Nurse license for the state in which they operate. + Current… more
    Erickson Living (05/13/25)
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  • Director of Nursing

    Sunrise Senior Living (Bowie, MD)
    …of approved college / school of nursing + Maintains a current state license as a Registered Nurse per state regulations. + A minimum of two (2) years' experience ... the highest quality standards for well-being. + Ensures proper utilization of the Resident Care Plan by all team...and service delivery as measured in the Quality Services Review (QSR) process and institutes with follow up measures… more
    Sunrise Senior Living (04/01/25)
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  • Clinical Letter Writer - UM & Specialty Experience…

    Evolent (Annapolis, MD)
    …+ Performs other duties as assigned. **Qualifications: Required and Preferred:** + Licensed registered nurse or LVN/LPN (current and unrestricted) + Minimum of ... direct clinical patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care environment** + **Cardiology and Oncology… more
    Evolent (04/25/25)
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