- Ascension Health (Baltimore, MD)
- …Provide health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
- AmeriHealth Caritas (Washington, DC)
- …Degree in Nursing (ASN) required; Bachelor's Degree in Nursing (BSN) preferred. + A Registered Nurse (RN) license in the District of Columbia in good standing ... efficiently document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria, care coordination,… more
- Humana (Washington, DC)
- …skills to make an impact** **Required Qualifications** + Compact licensure + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary ... of our caring community and help us put health first** The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and independent… more
- Zurich NA (Washington, DC)
- AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is seeking an AVP, Utilization Review & Pharmacy. This is a fully remote position, offering ... flexibility of a home-based office. As the AVP of Utilization Review & Pharmacy, you will lead...more years of experience in the Nursing areaAND + Registered Professional Nurse license in residential area… 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) ... for each two-week period will be provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): The contracted RN shall provide the following… 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 ... Ivyhill is currently seeking to hire a Registered Nurse (Non-Practicing) to support its...of Specialty Care Referrals, sustaining up-to-date Specialty Clinic Referral Review tools and booking guidance, complying with Referral and… 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
- Ascension Health (Baltimore, MD)
- …job transfer date required. American Heart Association or American Red Cross accepted. + Registered Nurse obtained prior to hire date or job transfer date ... required. Education: + Required professional licensure/certification AND 3 years of experience and 1 year of cumulative leadership experience required. **Additional Preferences** \#ATP **Why Join Our Team** Ascension associates are key to our commitment of… more
- Fresenius Medical Center (Hyattsville, 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
- Fresenius Medical Center (Baltimore, MD)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… 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. ... support in response to emergency situations. + Prepare chart documentation for review and counter signature by the physician. + Determine differential diagnosis. +… more
- Amergis (Columbia, MD)
- Salary: $53 / Hour The Registered Nurse - Hospice Case Manager is responsible for providing care, comfort and supportto terminally ill patients. The Registered ... the delivery of hospice patient carein various settings. The Registered Nurse demonstrates the abilityto make clinical...highest level of care. + Inform Team Leader of utilization of other team members, outside agencies, and community… more
- Immigration and Customs Enforcement (Washington, DC)
- …background in health care with extensive direct patient care experience as a registered nurse or advanced practice provider ( Nurse Practitioner/Physician ... preferably in correctional or detention setting. Case management and utilization review experience preferred. Correctional experience preferred. PHYSICAL… more
- CareFirst (Baltimore, MD)
- …of care and manage health care costs. We are looking for an experienced Registered Nurse and people leader with UM/CM experience living within the greater ... required work experience. **Licenses/Certifications Upon Hire Required:** Health Services\RN - Registered Nurse Active State Licensure and/or Compact State… more
- CareFirst (Baltimore, MD)
- …required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure Upon ... with dynamic goals resulting in the full and fair review of appeals and grievances designed to achieve corporate...Manager Upon Hire Preferred or + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred **Experience:** 5 years'… 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
- Ivyhill Technologies LLC (Bethesda, MD)
- …and able to perform all the duties and requirements of the Referral Registered Nurse and the the RM Reviewers. Requirements Qualified candidate must ... all incoming RM staff to be able to accurately review referrals utilizing the Specialty Referral Guideline (SRG) compliance...be a Licensed Registered Nurse (RN), with an unencumbered active… more
- Sunrise Senior Living (Arlington, 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 ... **If you're currently an ADON, Unit Manager, or Charge Nurse ready to take the next step in your...the highest quality standards for well-being. + Ensures proper utilization of the Resident Care Plan by all team… more