• Battelle Memorial Institute (Arlington, VA)
    …two years' nursing experience + Current, full, active, and unrestricted license as a Registered Nurse in any US State, the District of Columbia, Guam, Puerto ... Research and Analytics (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support of our government customer,… more
    DirectEmployers Association (11/05/25)
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  • Clinical Registered Nurse

    Cognizant (Washington, DC)
    …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
    Cognizant (11/15/25)
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  • Utilization Management Appeals Nurse

    Humana (Washington, DC)
    **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 ... SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action… more
    Humana (11/12/25)
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  • Utilization Management Nurse

    Humana (Washington, DC)
    **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) Compact license, with no… more
    Humana (11/13/25)
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  • Utilization Management Nurse

    Humana (Washington, DC)
    …make an impact** **Required Qualifications** + Associate's Degree or higher + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary ... health first** This is an opportunity to use your clinical knowledge and research skills to support the coordination,...an 8.5-hour shift between 7:00am - 5:00pm CST. The Utilization Management Nurse 2 uses knowledge, communication,… more
    Humana (11/12/25)
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  • Senior Clinical Nurse Specialist…

    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
    Immigration and Customs Enforcement (11/06/25)
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  • Utilization Management Reviewer

    AmeriHealth Caritas (Washington, DC)
    …standards in a fast-paced, high-volume environment. **Licensure:** + An active and unencumbered Registered Nurse license in the District of Columbia is required. ... SIGN ON BONUS** **Role Overview:** Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for… more
    AmeriHealth Caritas (09/01/25)
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  • Clinical UM Nurse

    CenterWell (Washington, DC)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
    CenterWell (11/12/25)
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  • UM Behavioral Health Nurse

    Humana (Washington, DC)
    …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... Facilities to obtain sufficient clinical information. The Utilization Management Behavioral Health Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
    Humana (11/15/25)
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  • Nurse Manager, RN

    Erickson Living (Springfield, VA)
    …(skilled nursing, long term care, assisted living or hospital) is required. + Current Registered Nurse license for the state in which they operate. + Current ... by Erickson Senior Living Join our team as the Nurse Manager, RN also known as the Clinical... clinical leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review, and Performance… more
    Erickson Living (10/24/25)
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  • Disease Management Nurse - Remote

    Sharecare (Washington, DC)
    …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
    Sharecare (10/22/25)
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  • Healthcare Clinical Documentation…

    Deloitte (Washington, DC)
    …certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, ... or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical ...clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health… more
    Deloitte (11/08/25)
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  • RN Director Clinical Practice (Home Health)

    BrightSpring Health Services (Arlington, VA)
    …a Medicare certified home health agency generally required + Currently licensed as a Registered Nurse (RN), in good standing in state of residence (additional ... Our Company BrightSpring Health Services Overview RN Director Home Health Clinical Practice Hybrid- Remote with 80% Travel Full-Time Provide oversight, leadership… more
    BrightSpring Health Services (08/26/25)
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  • Clinical Nursing Administrator, Per Diem…

    Howard University Hospital (Washington, DC)
    …nursing experience 3+ years nursing leadership experience in a hospital setting Current Registered Nurse License for the District of Columbia BLS through ... Clinical Nursing Administration Per Diem: As needed With...patients. The incumbent assists in the formulation of a nurse float pool and coordinates the daily use of… more
    Howard University Hospital (09/10/25)
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  • Denials Prevention Specialist, Clinician PRN

    Datavant (Washington, DC)
    clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
    Datavant (11/12/25)
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  • Director of Nursing RN

    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 ... not limited to the essential functions listed as follows: ** Clinical Care Delivery Operations** + Directs, supervises the management...highest quality standards for well being. + Ensures proper utilization of the Resident Care Plan by all team… more
    Sunrise Senior Living (10/06/25)
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  • Payment Integrity Clinician

    Highmark Health (Washington, DC)
    …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
    Highmark Health (11/14/25)
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