- MEDSTAR HEALTH (Columbia, MD)
- …locations. MedStar Health is the leading healthcare provider in Maryland, DC, and Virginia.The System Director of utilization is responsible for overseeing ... General Summary of PositionMedStar Health is looking for a System Director of UtilizationWith 10 nationally respected hospitals and over 500 specialty, urgent… more
- MEDSTAR HEALTH (Washington, DC)
- …services.Maintains timely and accurate documentation in the clinical software system per Clinical Operations department's policy.Monitors utilization of ... and abuse.Performs pre-authorization and pharmacy reviews and documents in PBMAes system when assigned.Performs telephonic ACD line coverage for Clinical Operations'… more
- MEDSTAR HEALTH (Clinton, MD)
- General Summary of PositionMedStar Southern Maryland is in search of a Director of Nursing for the Emergency Department. This position will be full time with varying ... improve the quality of life in our community. The Director of Nursing is a member of MedStar Health...care and implements a patient and nursing care delivery system which puts the patient first. Recognized as a… more
- MEDSTAR HEALTH (Laurel, MD)
- …the Operations Managers. May at times receive functional supervision from the VP Director , AVP Clinical Operations, and Medical Director . Must maintain a weight ... transfer.In collaboration with the Critical Care Transport Specialist - RN , monitors and evaluates invasive and non-invasive techniques/procedures and their… more
- Cognizant (Washington, DC)
- …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...submit the medical necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in… more
- Fresenius Medical Center (Clinton, MD)
- …+ Develops action plans for unexcused and missed treatments in collaboration with the Director . + Plans, coordinates and acts as the liaison for patient care as per ... management company. Maintains current knowledge of disease management software and systems as pertinent. **STAFF:** + Responsible for implementation of FMS staffing,… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …referral management process and the RM Team. Requirements Qualified candidate must be a Licensed Registered Nurse ( RN ), with an unencumbered active RN ... Ivyhill is currently seeking to hire a Registered Nurse (Non-Practicing) to support its...and full use of Referral Management (RM) information management systems . Will conduct reviews for capacity, capability, medical necessary,… more
- BrightSpring Health Services (Arlington, VA)
- …in a Medicare certified home health agency generally required + Currently licensed as a Registered Nurse ( RN ), in good standing in state of residence ... Our Company BrightSpring Health Services Overview RN Director Home Health Clinical Practice...precept + Acts as a clinical resource in EMR/EHR systems as necessary + Works with local clinical and… more
- Sunrise Senior Living (Silver Spring, MD)
- …of approved college / school of nursing + Maintains a current state license as a Registered Nurse per state regulations + A minimum of two (2) years' experience ... **COMMUNITY NAME** Bedford Court **Job ID** 2025-233875 **JOB OVERVIEW** The Director of Nursing Services is responsible for providing leadership and management… more
- BAYADA Home Health Care (Sterling, VA)
- **Join BAYADA as a Home Health Director - Falls Church, VA** Are you ready to lead with purpose in a dynamic and growing healthcare field? BAYADA Home Health Care is ... seeking an experienced and compassionate ** Director ** to manage operations at our **Falls Church, VA Medicare-certified Home Health office** . The ideal candidate… 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. ... Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ensuring… more
- HCA Healthcare (Reston, VA)
- …and OR Administrative Director in maintaining OR block scheduling and resource utilization . Provides data to be used by the Specialty Experts to improve OR ... purpose and integrity. We care like family! Jump-start your career as a RN Manager Surgery today with Reston Hospital Center. **Benefits** Reston Hospital Center… more
- Somatus (Mclean, VA)
- …utilizing basic nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs care management ... and Care Management Plan in Electronic Health Record and Care Management Systems as appropriate. + Coordinates care with central departments on assigned patient… 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 ... Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** Nurse Supervisor- IMC **Employment** **Type:** Full time **Shift:** Day **Location:**… more
