- Ascension (Harmans, MD)
- …at time of hire. Additional Preferences One year of recent experience in Utilization Management required. Local and national travel options are available ... options for post-discharge care. Requirements Licensure / Certification / Registration: Registered Nurse obtained prior to hire date or job transfer date required.… more
- LifeBridge Health (East Case, MD)
- Utilization Review Nurse RN - PRN Baltimore, MD SINAI HOSPITAL UTILIZATION REVIEW PRN - Day shift - 8:00am-4:30pm RN Other 92270 $50.00-$50.00 Posted: ... Cycle Management process and payors to ensure efficiency of utilization of resources, minimize losses and maximize reimbursement. Key Responsibilities: Medical… more
- LifeBridge Health (East Case, MD)
- Registered Nurse - Sinai Hospital - OROC Sign On... Designated provider team (MDs/ APPs) available with Care Management support JOB SUMMARY: As a member of the ... RAPID OBS Full-time w/Weekend Commitment - Day shift - 7:00am-7:30pm Staff Nurse 90568 $37.15-$57.58 Experience based Posted: October 23, 2025 Apply Now Save… more
- Yale New Haven Health (Lisbon, MD)
- …The Perioperative Experience. Performs Scrub And Related Duties With A Registered Nurse . Is Responsible For The Immediate Sterile Field And Instrumentation. Assists ... Provides Assistance To Nursing And Anesthesia Staff. Assists With Inventory Management As Well As Equipment Maintenance. Provides Any Supportive Duties That… more
- LifeBridge Health (Mcdonogh Run, MD)
- …Case Management Certification (CCM) within 3 years Must have Utilization Review experience CareerPriority Additional Information Who We Are: LifeBridge Health is ... Bonus Potential: 6,000 Randallstown, MD NORTHWEST HOSPITAL NW CARE MANAGEMENT Part-time w/Weekend Commitment - Day/Night rotation - Rotating-7am-730pm/7pm-730am RN… more
- Fresenius Medical Care (Annapolis, MD)
- …Classification of Disease (ICD) coding. Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. ... Test. Preferred but not required: 3 years supervisory or project/program management experience. Med/surg or ICU/CCU experience. PHYSICAL DEMANDS AND WORKING… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Annapolis, MD)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... Preferred **Experience:** 5 years Clinical nursing experience. 2 years Care Management and/or Utilization Management . **Preferred Qualifications:** +… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit (ICU), Emergency Department… more
- CVS Health (Annapolis, MD)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... of business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption… more
- Ascension Health (Baltimore, MD)
- …time of hire. **Additional Preferences** + One year of **recent** experience in Utilization Management required. + Local and national travel options are ... for post-discharge care. **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer date required. +… more
- Johns Hopkins University (Baltimore, MD)
- …guidelines of the department and institution and in accordance with the Nurse Practitioner-Physician Written Agreement required and approved by the State of Maryland ... and the Nurse Practice Act of the State of Maryland. Is...long-term effects of radiation and provides accurate and timely management for such side effects. + Provides education to… more
- Elevance Health (Hanover, MD)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... ** Nurse Reviewer I** **Virtual:** This role enables associates...required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… more
- Immigration and Customs Enforcement (Washington, DC)
- …health facility surveyors and in collaboration with the IHSC Medical Quality Management Unit. SUPERVISORY CONTROLS: The Clinical Senior Nurse Specialist, Medical ... clinical and administrative nursing support, and collaborating with the IHSC Chief Nurse in the Nursing Services Unit to implement initiatives aimed at enhancing… more
- Highmark Health (Annapolis, MD)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Johns Hopkins University (Baltimore, MD)
- The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for ... to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast of… more
