- Cognizant (Annapolis, MD)
- …need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate implementation of the clinical appeal process for ... and serves as a resource for associates within the Clinical Appeals and Analysis unit. We are...team-based performance as needed. **Licenses/Certifications** : + RN - Registered Nurse - State Licensure And/or Compact… more
- Johns Hopkins University (Baltimore, MD)
- …division in fulfilling its mission. **Minimum Qualifications** + Master's Degree in Nursing; Registered Nurse license and Certified as a Nurse Practitioner. ... our ambulatory GI practices located at White Marsh and Bayview. The Nurse Practitioner works collaboratively within a multidisciplinary health team to optimize team… more
- CVS Health (Annapolis, MD)
- …licensure in non-compact states as needed. + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of ... and other key stakeholders such as Medical Directors, account teams/ clinical liaisons, etc.) to ensure consistency in clinical... Appeals experience in Utilization Management + Must have experience… more
- CareFirst (Baltimore, MD)
- …Office programs. **Licenses/Certifications Required Upon Hire** : Health Services\RN - Registered Nurse - State Licensure and/or Compact State Licensure. ... authorization of services and approved claims. + Prepares retrospective reviews, case appeals , billing coordination, and clinical support. + Manages the analysis… more