- Cognizant (Washington, DC)
- …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
- 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 (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 (Washington, DC)
- …+ 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
- 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
- Koniag Government Services (Camp Springs, MD)
- …LLC,** a Koniag Government Services company, is seeking a PRN Occupational Health Registered Nurse to support **KPS** and our government customer in Camp ... score on the National Council Licensure Examination (NCLEX-RN) + Current active, unrestricted Registered Nurse license to practice in Maryland + Minimum of three… 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
- CenterWell (Washington, DC)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
- Sharecare (Washington, DC)
- …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
- Lincoln Financial (Washington, DC)
- …**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
- KBR (Arlington, VA)
- …and self-care. + Current licens ur e ; full , active, and unrestricted license as a Registered Nurse or Licensed Clinical Social Worker in one of any US ... Title: Special Operations Nurse Case Manager / Case Manager Part-Time (National...of professional health nursing principles, practices, and procedures in clinical settings in order to analyze the full scope… 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
- HCA Healthcare (Dulles, VA)
- …Crisis Intervention must be obtained within 30 days of employment start date** + ** Registered Nurse ** + **Bachelors Degree** + **2 years as a Nursing Manager, ... **Description** **Introduction** Do you have the career opportunities as a Nurse Manager Behavioral Health you want in your current role? We invest in what matters… more
- Erickson Living (Springfield, VA)
- …(skilled nursing, long term care, assisted living or hospital) is required. + Current Registered Nurse license for the state in which they operate. + Current ... in clinical leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review, and Performance Improvement/Risk Management/Safety… more
- BrightSpring Health Services (Arlington, VA)
- …a Medicare certified home health agency generally required + Currently licensed as a Registered Nurse (RN), in good standing in state of residence (additional ... Our Company BrightSpring Health Services Overview RN Director Home Health Clinical Practice Full-Time Arlington, VA Provide oversight, leadership and support… more
- Howard University Hospital (Washington, DC)
- …nursing experience 3+ years nursing leadership experience in a hospital setting Current Registered Nurse License for the District of Columbia BLS through ... Clinical Nursing Administration Per Diem: As needed With...patients. The incumbent assists in the formulation of a nurse float pool and coordinates the daily use of… more