- 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
- 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
- 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 (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
- 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
- AmeriHealth Caritas (Washington, DC)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- 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
- 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
- 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
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …Living Center (Freedom Way East) Post-Acute Rehabilitation and Long Term Care Registered Nurse provides care and counseling of persons of health and prevention of ... (Freedom Way East) Post-Acute Rehabilitation/Polytrauma and Long Term Care (LTC) Registered Nurse (RN) provides care and counseling of persons or in the promotion… more
- 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
- 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
- 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
- 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 (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
- 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 (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 (Baltimore, MD)
- …years clinically related experience working in Care Management , Home Health, Discharge Coordination and/or Utilization Review. **Preferred Qualifications:** ... the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience and...of care. Utilizing experience and skills in both case management and utilization management including… more
- CareFirst (Baltimore, MD)
- …years clinically related experience working in Care Management , Home Health, Discharge Coordination and/or Utilization Review. **Preferred Qualifications:** ... the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience and...of care. Utilizing experience and skills in both care management and utilization management , the… more
- CareFirst (Baltimore, MD)
- …5 years clinically related experience working in Care Management , Home Health, Discharge Coordination and/or Utilization Review. **Preferred Qualifications** ... the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience and...of care. Utilizing experience and skills in both case management and utilization management , the… more
