- Humana (Annapolis, MD)
- …to make an impact** **Required Qualifications** + An active, unrestricted Virginia Registered Nurse ( RN ) or Behavioral Health clinician license such as a ... health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management ( Behavioral Health) who will utilize their clinical skills to… more
- The Arora Group (Bethesda, MD)
- …an office in Behavioral Health in Building 19. QUALIFICATIONS OF THE REGISTERED NURSE CASE MANAGER ( RN ): Degree/Education: + Degree: Associates Degree ... Case Manager Nurse Currently recruiting a Registered Nurse ( RN ) Case Manager...Managers: Care Manager Certified (CMC) + Experience: + Referral Management / Utilization Management (RM/UM) experience. +… more
- Elevance Health (Washington, DC)
- …degrees of medical complexity and acuity. Participates in case and/or utilization management execution/decision making for managed member populations. Primary ... II HCMS is responsible for managing a team of physical and/or behavioral health practitioners in the development, implementation, and coordination of a comprehensive… more
- Elevance Health (Alexandria, VA)
- …should reside in Fort Lee or Charles City, VA. The **LTSS Service Coordinator RN Clinician** is responsible for overall management of member's case within the ... face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral … more
- Elevance Health (Washington, DC)
- … with telephonic assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, ... **Managed Care Coordinator Clinician Non RN ** **Location:** Remote, within 50 miles of an...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
- CareFirst (Baltimore, MD)
- …+ Ability to provide excellent internal and external customer service. **Licenses/Certifications** : RN - Registered Nurse - State Licensure And/or Compact ... **Experience:** 5 years clinically related experience working in Care Management , Discharge Coordination, Home Health, Utilization Review,...State Licensure RN - Registered Nurse in MD, VA or Washington,… more
- CareFirst (Baltimore, MD)
- …+ Ability to provide excellent internal and external customer service. **Licenses/Certifications** : RN - Registered Nurse - State Licensure And/or Compact ... **Experience:** 5 years clinically related experience working in Care Management , Discharge Coordination, Home Health, Utilization Review,...State Licensure RN - Registered Nurse in MD, VA or Washington,… more
- CareFirst (Baltimore, MD)
- …Health, Discharge Coordination and/or Utilization Review. **Licenses/Certifications Upon Hire Required:** RN - Registered Nurse - Active State Licensure ... of care utilizing experience and skills in both case management and utilization management including...And/or Compact State Licensure RN - Registered Nurse in MD,… more
- CareFirst (Baltimore, MD)
- …application protocol and regulatory standards. **QUALIFICATIONS:** **Licenses and Certifications Required:** + RN - Registered Nurse - State Licensure And/or ... Compact State Licensure. + CCM/ACM or other RN Board Certified certification in case management ...**Experience:** 5 years clinically related experience working in Care Management , Discharge Coordination, Home Health, Utilization Review,… more
- CareFirst (Owings Mills, MD)
- …**QUALIFICATIONS:** **Education Level:** High School Diploma or GED. **Licenses/Certifications Upon Hire:** + RN - Registered Nurse - State Licensure And/or ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of...**Preferred Qualifications:** + 2 years experience in Medical Review, Utilization Management or Case Management … more
- Elevance Health (King George, VA)
- …contract. **Preferred Skills, Knowledge, and Experience:** + Previous experience with Utilization Management preferred. + Computer experience and experience ... with telephonic assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health,… more
- Amentum (Arlington, VA)
- …are interested in personnel with technical managerial, and/or financial management experience supporting Government technology development projects, preferably in ... devices, diagnostics, and digital health domains + Software development and management + Electronic Health Record and Cybersecurity, redundant backup system,… more
- Elevance Health (Fairfax, VA)
- …type of experience may be required based upon state law and contract requirements. + LMHP, RN /LPN field of study preferred. + Behavioral /Mental Health experience ... A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and… more