- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Trinity Health (Silver Spring, MD)
- …management or related field, with 2+ years in a leadership role in case management , utilization review , or similar areas. + Extensive understanding of ... of hospital staff in inpatient care coordination, social work, utilization review , and discharge planning. + Collaborate...payer mechanisms and clinical utilization management . + Strong interpersonal skills with… more
- Fresenius Medical Center (Alexandria, VA)
- …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
- Ivyhill Technologies LLC (Bethesda, MD)
- …management services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for timely review of Right of First ... RM Team. Requirements Qualified candidate must be a Licensed Registered Nurse ( RN ), with an...have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management … more
- Highmark Health (Washington, DC)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Highmark Health (Washington, DC)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Ivyhill Technologies LLC (Bethesda, MD)
- … Nurse and the the RM Reviewers. Requirements Qualified candidate must be a Licensed Registered Nurse ( RN ), with an unencumbered active RN license ... Ivyhill is currently seeking to hire Referral Management ( RN ) Training Manager to support...have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management … more
- Guardian Life (Washington, DC)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Erickson Living (Silver Spring, MD)
- …of medical practice; insurance benefit structures and related legal/medical issues; and utilization review and quality assurance procedures. Please note that ... consecutive year!_** Join our 5-star rated team as a RN Case Manager (also known as Care Coordinator, Erickson...+ Researches and selects care options as appropriate. The nurse care coordinator may utilize a range of alternative,… more
- BAYADA Home Health Care (Gaithersburg, MD)
- **BAYADA Home Health Care** is seeking a full-time ** Registered Nurse ( RN ),** **Physical Therapist (PT), Occupational Therapist (OT) or Speech Language ... and procedures. Rehab Managers are also accountable for internal case management , field staff evaluation and development. The successful Physical Therapist,… more
- Fresenius Medical Center (Alexandria, VA)
- …dialysis clinic. You will collaborate with the Medical Director and the Charge Nurse regarding the provision of quality patient care in the dialysis clinic. ... data collections and auditing activities. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review… more