- 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
- AmeriHealth Caritas (Washington, DC)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more