- 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
- 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 (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
- CVS Health (Annapolis, MD)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… more
- Fresenius Medical Center (Towson, MD)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- 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
- Immigration and Customs Enforcement (Washington, DC)
- …ensuring needed interpretation and/or translations services are available. d. The correctional registered nurse practices ethically per the Code of Ethics for ... and Certifications Required: a. Nursing License- Must be a Registered Nurse (RN).i. Maintains current/documented professional licensure. (It… more
- AmeriHealth Caritas (Washington, DC)
- …required; Bachelor's Degree in Nursing (BSN) preferred + Minimum of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit ... reviews within a managed care organization preferred **Licensure** + Active and unencumbered Registered Nurse license in the District of Columbia + Valid and… more
- CareFirst (Baltimore, MD)
- …required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure Upon ... authorization, appropriateness of care determination and benefit coverage. Leveraging clinical expertise and critical thinking skills, the Utilization...Hire Required + CNS- Clinical Nurse … more
- Ivyhill Technologies LLC (Bethesda, MD)
- Ivyhill is currently seeking to hire a Registered Nurse (Non-Practicing) to support its contract with the Integrated Referral Management and Appointing Center ... and referral management services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for timely review of… 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 ... 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
- Trinity Health (Silver Spring, MD)
- …1 Benefits, 10k Sign-on Bonus & More** **Position Overview** As a Home Health Registered Nurse , you'll provide in-home skilled nursing care to patients by ... this role offers a rewarding opportunity to apply your clinical expertise in a more independent, patient-focused environment. **Why...an approved Nursing education program, BSN preferred. + Current Registered Nurse licensure in the state of… more
- Trinity Health (Silver Spring, MD)
- …applicable):** + Current licensure by the Maryland State Board of Nursing as a Registered Nurse . + BLS certified; additional Life Support training as applicable ... **Employment Type:** Full time **Shift:** Rotating Shift **Description:** **General Summary:** The Nurse in Charge (NIC) is a designated clinical leader for a… more
- CareFirst (Baltimore, MD)
- …the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure. ... programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Clinical Utilization Management **Equal Employment Opportunity** CareFirst… more
- CVS Health (Annapolis, MD)
- …a member's overall wellness through integration. - Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and ... functions as well as smooth transition to programs and plans. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and… more
- BAYADA Home Health Care (Towson, MD)
- …Living in **Pikesville / Towson, MD** **_._** Are you a solutions-oriented, team-focused ** Registered Nurse , Licensed Practical Nurse or Therapist (Physical ... members to deliver on our differentiated offerings. Through the utilization of outcome driven data analytics, this role will...professional growth. **Qualifications:** + Current MD licensure as a Registered Nurse , Licensed Practical Nurse ,… more
- Humana (Annapolis, MD)
- …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... of action. The Utilization Management Behavioral Health Nurse uses clinical knowledge, communication skills, and...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Johns Hopkins University (Baltimore, MD)
- …and rapidly changing environment. **Minimum Qualifications** + Master's Degree in Nursing. + Registered Nurse license and Certified as a Nurse Practitioner. ... guidelines of the department and institution and in accordance with the Nurse Practitioner-Physician Written Agreement required and approved by the State of Maryland… more
- 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 ... to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast… more
- Johns Hopkins University (Baltimore, MD)
- …while maintaining patient confidentiality. **Minimum Qualifications** + Master's Degree in Nursing. + Registered Nurse license and Certified as a Nurse ... consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and...process is required prior to start date**_ Classified Title: Nurse Practitioner Job Posting Title (Working Title): Nurse… more