- Cognizant (Annapolis, MD)
- …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
- Humana (Annapolis, MD)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- CVS Health (Annapolis, MD)
- …both verbal and written **Required Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in ... 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 and… more
- Fresenius Medical Center (Clinton, MD)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
- Veterans Affairs, Veterans Health Administration (Baltimore, MD)
- …of the EDRP application. Former participants ineligible to apply Responsibilities The Registered Nurse (RN) functions interdependently in carrying out the ... 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… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …Community Living Center (Freedom Way East) Post-Acute Rehabilitation and Long Term Care Registered Nurse provides care and counseling of persons of health and ... Center (CLC) (Freedom Way East) Post-Acute Rehabilitation/Polytrauma and Long Term Care (LTC) Registered Nurse (RN) provides care and counseling of persons or in… more
- CVS Health (Annapolis, MD)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… 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 Center ... and referral management services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for timely review of… more
- Humana (Annapolis, MD)
- **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)** in the (appropriate state)… more
- Trinity Health (Silver Spring, MD)
- …1 Benefits, 10k Sign-on Bonus & More** **Position Overview** As a Home Health Registered Nurse , you'll provide in-home skilled nursing care to patients by ... this role offers a rewarding opportunity to apply your clinical expertise in a more independent, patient-focused environment. **Why...an approved Nursing education program, BSN preferred. + Current Registered Nurse licensure in the state of… more
- CareFirst (Baltimore, MD)
- …Office programs. **Licenses/Certifications Required Upon Hire** : Health Services\RN - Registered Nurse - State Licensure and/or Compact State Licensure. ... approved claims. + Prepares retrospective reviews, case appeals, billing coordination, and clinical support. + Manages the analysis of utilization patterns, such… more
- 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
- Centene Corporation (Annapolis, MD)
- …required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required + For ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Johns Hopkins University (Baltimore, MD)
- …and rapidly changing environment. **Minimum Qualifications** + Master's Degree in Nursing. + Registered Nurse license and Certified as a Nurse Practitioner. ... guidelines of the department and institution and in accordance with the Nurse Practitioner-Physician Written Agreement required and approved by the State of Maryland… 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 ... to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast… more
- Sharecare (Annapolis, MD)
- …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
- 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… more
- Lincoln Financial (Annapolis, MD)
- …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible… more
- Trinity Health (Silver Spring, MD)
- …licensure by the Maryland State Board of Nursing or Compact State as a Registered Nurse . + BLS certification (American Heart Association) + Department specific ... Advancement Program + **Location:** Holy Cross Health, Silver Spring, MD **Description:** The Nurse Supervisor is a designated clinical leader for a patient care… more
- CareFirst (Baltimore, MD)
- …required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure. + RN ... Utilizing experience and skills in both care management and utilization management, the Onsite Clinical Navigator will...- Registered Nurse in MD, VA or Washington,...- Registered Nurse in MD, VA or Washington, DC Upon Hire… more