• Home Care Evolution (Gaithersburg, MD)
    …time off Vision insurance Job Overview: We are seeking a dedicated and experienced Registered Nurse (RN) to join our Home Health Agency. The ideal candidate will ... ensure a seamless transition of care from hospital to home . OASIS Utilization : Proficiently use OASIS to...compliance with care plans. Qualifications: Active and unrestricted Registered Nurse (RN) license in the state of Virginia. Minimum… more
    Upward (08/03/25)
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  • Home Care Evolution (Gaithersburg, MD)
    Replies within 24 hours Job Overview: We are seeking a dedicated and experienced Registered Nurse (RN) to join our Home Health Agency. The ideal candidate will ... ensure a seamless transition of care from hospital to home . OASIS Utilization : Proficiently use OASIS to...compliance with care plans. Qualifications: Active and unrestricted Registered Nurse (RN) license in the state of Virginia. Minimum… more
    Upward (08/04/25)
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  • Utilization Management Nurse

    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...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
    Humana (09/12/25)
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  • SNF Utilization Management RN…

    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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (09/12/25)
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  • Utilization Management Manager…

    CareFirst (Baltimore, MD)
    …week. **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages ... expected to work a portion of their week from home and a portion of their week at a...medical practices and insurance benefit structures. + Proficient in utilization management processes, standards, and managed care.… more
    CareFirst (10/11/25)
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  • Registered Nurse - Home Health 7-7…

    WellSpan Health (Gettysburg, PA)
    …plan of care, the patient's diagnosis, corporate policy and procedures and the Nurse Practice Act. Carries primary care management functions for assigned ... Eligible **General Summary** Provides professional nursing services to individuals in the home through a process of nursing assessment, planning, care and evaluation… more
    WellSpan Health (10/03/25)
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  • Full-Time Home Health Registered…

    Trinity Health (Silver Spring, MD)
    …Counties** **Day 1 Benefits, 10k Sign-on Bonus & More** **Position Overview** As a Home Health Registered Nurse , you'll provide in- home skilled nursing care ... **Employment Type:** Full time **Shift:** **Description:** **Looking for Full-Time Home Health RNs to service our patients in and...savings that make a difference. + **Supportive Leadership** Our management team is here to help you succeed every… more
    Trinity Health (08/26/25)
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  • Disease Management Nurse - Remote

    Sharecare (Annapolis, MD)
    …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
    Sharecare (09/13/25)
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  • Nurse Practitioner (Radiation Oncology…

    Johns Hopkins University (Baltimore, MD)
    …guidelines of the department and institution and in accordance with the Nurse Practitioner-Physician Written Agreement required and approved by the State of Maryland ... and the Nurse Practice Act of the State of Maryland. Is...long-term effects of radiation and provides accurate and timely management for such side effects. + Provides education to… more
    Johns Hopkins University (07/31/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Annapolis, MD)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse more
    CVS Health (10/15/25)
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  • Pre-Authorization Nurse

    Humana (Annapolis, MD)
    …as Interqual, etc.) ​ **Preferred Qualifications** + Utilization Review/Quality Management experience + BA/BSN degree **Work-At- Home Requirements** + WAH ... of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following… more
    Humana (10/14/25)
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  • Licensed Practical Nurse -Outpatient…

    WellSpan Health (Gettysburg, PA)
    …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical ...1800, Adams County includes the borough of Gettysburg, Pennsylvania. Home to more than 100,000 residents, the town is… more
    WellSpan Health (10/06/25)
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  • Consultant, Nurse Disability I

    Lincoln Financial (Annapolis, MD)
    …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at ...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position… more
    Lincoln Financial (10/10/25)
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  • Licensed Practical Nurse - Thomas Hart…

    WellSpan Health (York, PA)
    …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... Experience:** + 1 year Clinical nursing experience. Required **Licenses:** + Licensed Practical Nurse Upon Hire Required or + Licensed Practical Nurse Multi… more
    WellSpan Health (10/11/25)
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  • Appeals Nurse

    Evolent (Annapolis, MD)
    …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
    Evolent (10/11/25)
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  • Nurse Supervisor - Dialysis

    Trinity Health (Silver Spring, MD)
    …high-quality care to patients with complex renal needs. As the designated Nurse Supervisor, you'll coordinate staffing, resource management , and clinical ... **Employment Type:** Full time **Shift:** Day Shift **Description:** **Clinical Nurse Supervisor - Dialysis** **Location: Holy Cross Hospital** **Employment Type:… more
    Trinity Health (10/02/25)
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  • Manager Clinical Operations Registered…

    WellSpan Health (York, PA)
    …leadership and Medical Group practice experience. Required + Lean Daily Management experience. Preferred **Licenses:** + Licensed Registered Nurse Upon ... safety and efficient care. Assists the Director of Clinical Operations in management of staff to deliver high quality, patient-centered care. Assists with directing… more
    WellSpan Health (10/08/25)
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  • Part-Time (24 Hours) Home Care RN…

    Trinity Health (Silver Spring, MD)
    …Type:** Part time **Shift:** Weekend Shift **Description:** **Position Purpose:** Our Home Care RNs (Primary Care Nurses) provides primary nursing care to ... home based care patients as ordered by the physician,...and LPNs as needed. Provides therapeutic intervention, overall care management and achievement of top decile client outcomes and… more
    Trinity Health (09/15/25)
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  • Care Management Supervisor (Hybrid)

    CareFirst (Baltimore, MD)
    …Active State Licensure and/or Compact State Licensure. **Experience:** 5 years experience in Utilization Management or Case Management at CareFirst BlueCross ... **Resp & Qualifications** **PURPOSE:** The Care Management Supervisor supervises, directs and coordinates the activities...care costs. **We are looking for an experienced Registered Nurse and people leader with UM/CM experience** **living within… more
    CareFirst (10/01/25)
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  • Onsite Care Management Supervisor (Hybrid)

    CareFirst (Baltimore, MD)
    …in addition to the required work experience. **Experience:** 3 years Care Management , Discharge Coordination, Home Health, Utilization Review, Disease ... **Resp & Qualifications** **PURPOSE:** The Inpatient Management Onsite Care Management Supervisor will direct and coordinate the activities of Onsite Care … more
    CareFirst (10/14/25)
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