- Veterans Affairs, Veterans Health Administration (Baltimore, MD)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... standards and performance measures. He/she will utilize emergency and bed management software, along with UM data, to manage admission recommendations and… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** Hybrid work schedule available. Monday-Friday, 8:00AM-4:30PM. + **Facility:** St. Agnes ... and coordinate compliance to federally mandated and third party payer utilization management rules and regulations. **Requirements** Licensure / Certification… more
- CVS Health (Washington, DC)
- …both verbal and written. **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care setting. + Must have active ... current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and… more
- CVS Health (Washington, DC)
- …And we do it all with heart, each and every day. Requisition Job Description Utilization Management is a 24/7 operation and work schedule may include weekends ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...**Required Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current… more
- Ascension Health (Baltimore, MD)
- **Details** + **Department:** Utilization Management + **Schedule:** Hybrid work schedule available. Monday-Friday, 8:00AM-4:30PM. + **Hospital:** Ascension St. ... development and evaluation of staff **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer… 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 (DHO) ... be provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): The contracted...Managers: Care Manager Certified (CMC) + Experience: + Referral Management / Utilization Management (RM/UM) experience. +… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... education, orientation, competencies and providing quality improvement and outcomes utilization consultation. Responsibilities The primary purpose of the Intravenous… more
- Sharecare (Washington, DC)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting...disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations… 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 ... services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for...have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management … more
- Koniag Government Services (Camp Springs, MD)
- Occupational Health Registered Nurse Camp Springs, MD, USA Req #280 Wednesday, April 30, 2025 **Koniag Professional Services, LLC,** a Koniag Government Services ... company, is seeking a full time Occupational Health Registered Nurse to support **KPS** and our...Prepare and submit required reports, including quarterly and annual utilization reports + Manage and maintain medical equipment and… more
- CVS Health (Annapolis, MD)
- …and industry knowledge, remaining conscious of industry trends **Required Qualifications:** + Registered Nurse with current license in state of employment; ... Skilled Nursing (SNF) and Assisted Living (ALF) facilities. The Clinical Nurse Specialist/Infusion Educator for LTC (Long Term Care) will work collaboratively… more
- Humana (Washington, DC)
- …+ Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time ... + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming accreditation standards… more
- Fresenius Medical Center (Lanham, MD)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... by working with the Vice President of Quality and other organization management to ensure that organization/ASC policies and procedures are followed. + Responsible… more
- Fresenius Medical Center (Baltimore, MD)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Evolent (Washington, DC)
- …As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- Ascension Health (Baltimore, MD)
- …and salary range at the time of the offer._ **Responsibilities** Manage assigned Registered Nurse (RN) case managers, related activities and workflow to ensure ... management issues. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Maryland Board of Nursing obtained… more
- Trinity Health (Silver Spring, MD)
- …you will need:** + Current licensure by the Maryland State Board as a Registered Nurse + BLS certification (issued through the American Heart Association) + ... Type:** Full time **Shift:** 12 Hour Day Shift **Description:** **Job Title:** Nurse In Charge/ Nurse Supervisor **Unit:** SICU/NCCU **Employment Type:** Full… more
- Johns Hopkins University (Columbia, MD)
- …fluids with blood borne pathogens. **Minimum Qualifications** + Master's Degree in nursing. + Registered Nurse license and certified as a Nurse Practitioner ... The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for… 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 ... The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for… more
- Johns Hopkins University (Baltimore, MD)
- …fluids with blood borne pathogens. **Minimum Qualifications** + Master's Degree in Nursing. + Registered Nurse license and Certified as a Nurse Practitioner. ... to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast of… more