- The Arora Group (Bethesda, MD)
- …+ The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse ( RN ) and pre-certification clerk. + The ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently...or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as… more
- Elevance Health (Woodbridge, VA)
- RN Utilization Review Nurse (Washington DC Medicaid) JR149756 **Location** : This role requires associates to be in-office 4 days per week, Monday - ... located at 609 H. Street NE. The **Medical Management Nurse ** is responsible for review of the...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more
- The Arora Group (Bethesda, MD)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse ( RN ) Case Manager to work the Directorate of Healthcare Operations ... be provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER ( RN ):...cost diagnoses. + Independently perform difficult and complex assessment, review , coordination, planning, monitoring, evaluation and analysis of cases.… more
- Fresenius Medical Center (Waldorf, MD)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Sharecare (Washington, DC)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …referral management services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for timely review of Right of ... of Specialty Care Referrals, sustaining up-to-date Specialty Clinic Referral Review tools and booking guidance, complying with Referral and...RM Team. Requirements Qualified candidate must be a Licensed Registered Nurse ( RN ), with an… more
- Highmark Health (Washington, DC)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- Ivyhill Technologies LLC (Bethesda, MD)
- … Nurse and the the RM Reviewers. Requirements Qualified candidate must be a Licensed Registered Nurse ( RN ), with an unencumbered active RN license ... Ivyhill is currently seeking to hire Referral Management ( RN ) Training Manager to support its contract with...all incoming RM staff to be able to accurately review referrals utilizing the Specialty Referral Guideline (SRG) compliance… more
- Evolent (Washington, DC)
- … Nurse + Associate or Bachelors in Nursing (Must be a Registered Nurse ) + Experience as an RN in a Pain Management setting is preferred + Strong ... You'll Be Doing:** Job description: As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way… more
- Erickson Living (Springfield, VA)
- …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... (skilled nursing, long term care, assisted living or hospital) is required. + Current Registered Nurse license for the state in which they operate. + Current… more
- BrightSpring Health Services (Arlington, VA)
- …Education: + Bachelor's Degree in Nursing or the equivalent + Currently licensed as a Registered Nurse ( RN ), in good standing in state of residence ... ensuring field clinical staff meet daily/weekly/monthly/quarterly and annual requirements + Review 's incident report trends - ensures follow up as needed. Conducts… more
- Lincoln Financial (Washington, DC)
- …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like… more
- The Arora Group (Fort Belvoir, VA)
- Licensed Practical Nurse (LPN) - Patient Centered Medical Home (PCMH) Nurse Currently recruiting a Licensed Practical Nurse (LPN) - Patient Centered Medical ... required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN) - PATIENT CENTERED MEDICAL HOME (PCMH): +...remind them of appointments or results as directed by RN or provider. + Assist provider with treatment and… more
- HCA Healthcare (Fairfax, VA)
- …you passionate about delivering patient-centered care?** Submit your application for Operating Room Nurse Float Pool position and spend more time at the bedside with ... the patient. We are looking for Float Pool OR RN 's that are willing to float to our three...Summary and Qualifications** We are seeking an Operating Room Nurse for our ambulatory surgery center who demonstrates the… more
- HCA Healthcare (Reston, VA)
- …set us apart from any other healthcare provider. We are seeking an Operating Room Nurse to join our healthcare family. **We are now offering a $20,000 sign on bonus ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- Evolent (Washington, DC)
- …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- Immigration and Customs Enforcement (Washington, DC)
- …extended periods of time. Education REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES: Must be a Registered Nurse , Advanced Practice Registered Nurse or ... cases. Utilize IHSC electronic health record for IHSC noncitizen patients. Review , prioritize, initiate, assign and disseminate all serious clinically significant… more
- Sunrise Senior Living (Fort Belvoir, VA)
- …of approved college / school of nursing + Maintains a current state license as a Registered Nurse per state regulations. + A minimum of two (2) years' experience ... the highest quality standards for well-being. + Ensures proper utilization of the Resident Care Plan by all team...and service delivery as measured in the Quality Services Review (QSR) process and institutes with follow up measures… more
- KBR (Washington, DC)
- …compliance in meeting care goals. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and ... + Current licens ur e ; full , active, and unrestricted license as a Registered Nurse or Licensed Clinical Social Worker in one of any US State, the District of… more
- KBR (Washington, DC)
- …compliance in meeting care goals. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and ... and self-care. + Current licensure; full, active, and unrestricted license as a Registered Nurse or Licensed Clinical Social Worker in one of any US State, the… more