- 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 ... ideas and community-centered care. About the Role/Unit: The PRN Utilization Review RN at Sinai...hospital resources Requirements: Education: BSN preferred; ADN required Licensure: Registered Nurse License - Current Maryland license… more
- Fresenius Medical Care (Annapolis, 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 loss review . Responsible for all required network reporting and on-site state or… more
- LifeBridge Health (Mcdonogh Run, MD)
- …specialized field Associate Degree in Nursing required, Bachelor of Nursing preferred. Maryland Registered Nurse License ( RN ) American Heart Association CPR ... Emergency Department Care Coordinator ( RN ) Sign On Bonus Potential: 6,000 Randallstown, MD...Case Management Certification (CCM) within 3 years Must have Utilization Review experience CareerPriority Additional Information Who… more
- Fresenius Medical Center (Towson, 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
- CVS Health (Annapolis, MD)
- …however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating ... - Through the use of clinical tools and information/data review , conducts an evaluation of member's needs and benefit...**Required Qualifications** Must have an active, current and unrestricted RN licensure in the state of residence and be… more
- Humana (Annapolis, MD)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- CenterWell (Annapolis, MD)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
- AmeriHealth Caritas (Washington, DC)
- …(BSN) preferred + Minimum of 3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit (ICU), Emergency Department (ED), ... reviews within a managed care organization preferred **Licensure** + Active and unencumbered Registered Nurse license in the District of Columbia + Valid and… 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 Review Specialist will perform prospective,… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... accreditation standards and federal/state regulations and general principles relating to utilization review . + Computer skills, including Microsoft Office… more
- Immigration and Customs Enforcement (Washington, DC)
- …Qualifications-Licenses and Certifications Required: a. Nursing License- Must be a Registered Nurse ( RN ).i. Maintains current/documented professional ... ensuring needed interpretation and/or translations services are available. d. The correctional registered nurse practices ethically per the Code of Ethics for… more
- Humana (Annapolis, MD)
- …timeframe **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) Compact license, with no disciplinary action ... caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes...Health Provider Disputes based on the business need + Review and extract information from claims + Work in… more
- Amergis (Baltimore, MD)
- …and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in decision-making ... The RN Case Manager is responsible for coordinating continuum...of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical… 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)
- …while maintaining patient confidentiality. **Minimum Qualifications** + Master's Degree in Nursing. + Registered Nurse license and Certified as a Nurse ... support in response to emergency situations. + Prepare chart documentation for review and counter signature by the physician. + Determine differential diagnosis. +… 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. ... The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for… more
- Elevance Health (Hanover, MD)
- ** Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... time,** **with rotating weekends.** **New Grads are encouraged to apply!** The ** Nurse Reviewer I** will be responsible for conducting preauthorization, out of… more
- Highmark Health (Annapolis, MD)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- Evolent (Annapolis, MD)
- …mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance ... for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices...UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory… more
- CareFirst (Baltimore, MD)
- …Assignments are subject to change based on evolving business needs. **Licenses/Certifications** : RN - Registered Nurse - State Licensure And/or Compact ... working in Care Management, Home Health, Discharge Coordination and/or Utilization Review . **Preferred Qualifications** : + Knowledge...State Licensure: RN - Registered Nurse in MD, VA or Washington,… more
