- Ascension (Harmans, MD)
- …treatment options for post-discharge care. Requirements Licensure / Certification / Registration: Registered Nurse obtained prior to hire date or job transfer ... of hire. Additional Preferences One year of recent experience in Utilization Management required. Local and national travel options are available depending on… 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 ... of hospital resources Requirements: Education: BSN preferred; ADN required Licensure: Registered Nurse License - Current Maryland license or Compact Multistate… more
- LifeBridge Health (East Case, MD)
- Registered Nurse - Sinai Hospital - OROC...Job Saved Summary Outpatient Rapid Observation Center (OROC) - RN Join us at the forefront of patient care! Be ... Full-time w/Weekend Commitment - Day shift - 7:00am-7:30pm Staff Nurse 90568 $37.15-$57.58 Experience based Posted: October 23, 2025... Designated provider team (MDs/ APPs) available with Care Management support JOB SUMMARY: As a member of the… more
- LifeBridge Health (Mcdonogh Run, MD)
- …Bachelor of Nursing preferred. Maryland Registered Nurse License ( RN ) American Heart Association CPR Certification Case Management Certification (CCM) ... Emergency Department Care Coordinator ( RN ) Sign On Bonus Potential: 6,000 Randallstown, MD NORTHWEST HOSPITAL NW CARE MANAGEMENT Part-time w/Weekend Commitment -… 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. ... of education and experience. Graduate of an accredited School of Nursing ( RN ). Current appropriate state licensure. EXPERIENCE AND SKILLS: Required: 6 years business… more
- Yale New Haven Health (Lisbon, MD)
- …Patient Throughout The Perioperative Experience. Performs Scrub And Related Duties With A Registered Nurse . Is Responsible For The Immediate Sterile Field And ... Provides Assistance To Nursing And Anesthesia Staff. Assists With Inventory Management As Well As Equipment Maintenance. Provides Any Supportive Duties That… more
- Parexel (Annapolis, MD)
- **Job Title:** Data Management Lead (Medical Affairs) - Oncology **Location:** Fully Remote (US based) Must be able to accommodate West Coast hours. **About Us:** At ... solutions. We are seeking a dynamic and experienced Data Management Lead to join our team. If you have...practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable… more
- Organon & Co. (Annapolis, MD)
- …Structure and Function. **Preferred Education, Experience and Skills** + PharmD, APRN, RN , MBA preferred. + Previous large/strategic account management role. + ... as well as other extended account team members to maximize appropriate utilization of Organon products. Integrates Senior Leadership into the overall business… 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...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- CVS Health (Annapolis, MD)
- …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CareFirst (Baltimore, MD)
- …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization ...State Licensure Upon Hire Required + CNS-Clinical Nurse Specialist Preferred **Experience:** 5 years Clinical nursing experience.… 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...of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit… more
- Elevance Health (Washington, DC)
- …each week. The office is located at 609 H. Street NE.** The **Manager of Utilization Management ** **ll** is responsible for managing a team of physical health ... acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member...as aligned to license which includes 3 years prior management experience + Current active unrestricted RN … more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination… more
- CenterWell (Annapolis, MD)
- …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… more
- Ascension Health (Baltimore, MD)
- …options for post-discharge care. **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer ... hire. **Additional Preferences** + One year of **recent** experience in Utilization Management required. + Local and national travel options are available… more
- CVS Health (Annapolis, MD)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating… 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
- Highmark Health (Annapolis, MD)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
