- 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
- CenterWell (Annapolis, MD)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit (ICU), Emergency Department… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... expected to work a portion of their week from home and a portion of their week at a...business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement,… more
- Veterans Affairs, Veterans Health Administration (Baltimore, MD)
- …utilization . Demonstrates leadership in delivering and improving holistic, home -based care through collaborative strategies with others. - Critical-Thinking ... Health in an environment that supports personalized and proactive care. Responsibilities Home Based Primary Care (HBPC) Patient Aligned Care Team (PACT) Staff… 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
- BAYADA Home Health Care (Towson, MD)
- **BAYADA Senior Living Solutions** , a specialty offering of BAYADA Home Health Care, was created to address the unique needs of senior living communities, and their ... Towson, MD** **_._** Are you a solutions-oriented, team-focused **Registered Nurse , Licensed Practical Nurse or Therapist (Physical...create alignment to common goals across multiple levels of management ? Would you like to be viewed as a… more
- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- CVS Health (Annapolis, MD)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the… 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
- 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
- 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
- Evolent (Annapolis, MD)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
- Fresenius Medical Center (Towson, MD)
- …Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
- CareFirst (Baltimore, MD)
- … - State Licensure and/or Compact State Licensure. **Experience:** 3 years Care Management , Discharge Coordination, Home Health, Utilization Review, Disease ... County/Washington DC or Northern Virginia metropolitan area.** **PURPOSE:** The Inpatient Management Care Management Supervisor will direct and coordinate the… 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
- CVS Health (Annapolis, MD)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... and every day. **This is a remote work from home role anywhere in the US with virtual training.**...residence.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health.… more
- CareFirst (Baltimore, MD)
- …or Washington. **Experience:** 5 years clinically related experience working in Care Management , Discharge Coordination, Home Health, Utilization Review, ... **PURPOSE:** This position will support the Maryland government programs care management team, specifically the Medicare Advantage line of business. The Care… more