- Humana (Washington, DC)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Evolent (Washington, DC)
- …Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …to benefits of interventions and their outcomes; Knowledge of resources planning, management , and utilization ; Knowledge of County personnel policies and ... Public Health Nurse IV - Clinical Nurse Informatics...public health nursing programs; Knowledge of budget and financial management principles and practices to include assessing costs relative… more
- Trinity Health (Silver Spring, MD)
- …and patients often require cardiac telemetry monitoring and/or mechanical ventilator support. The Nurse in Charge (NIC) is a designated clinical leader for a patient ... and accountable for: + Cost effective decision-making regarding operations including utilization and application of resources. (ie, human resources, patient care… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …nursing program. Must have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management (UM) experience is preferred. ... Ivyhill is currently seeking to hire a Registered Nurse (Non-Practicing) to support its contract with the Integrated Referral Management and Appointing Center… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- Clinic Public Health Nurse II Print (https://www.governmentjobs.com/careers/fairfaxcounty/jobs/newprint/4773528) Apply Clinic Public Health Nurse II Salary ... in developing appropriate health care plans; Documents health care service utilization , client outcomes, and information regarding referrals and follow-up of… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Part time **Shift:** Weekend Shift **Description:** **Job Title:** Nurse In Charge position for the Operating Room **Employment Type:** ... Advancement Program + **Location:** Holy Cross Health, Silver Spring, MD **Description:** The Nurse in Charge (NIC) is a designated clinical leader for a patient… more
- Erickson Living (Silver Spring, MD)
- Location: Riderwood Village by Erickson Senior Living The Nurse Practitioner, Employee Health and Well-Being, under general supervision from the National Medical ... health, provides high quality, efficient and cost-effective acute care, injury management , community outbreak management , new hire assessments, immunizations,… more
- Koniag Government Services (Camp Springs, MD)
- …Koniag Government Services company, is seeking a full time Occupational Health Registered Nurse to support **KPS** and our government customer in Camp Springs, MD. ... provided. + Prepare and submit required reports, including quarterly and annual utilization reports + Manage and maintain medical equipment and supplies + Provide… more
- Trinity Health (Silver Spring, MD)
- …and accountable for: + Cost effective decision-making regarding operations including utilization and application of resources. (ie, human resources, patient care ... including orientation and training. + Participating in performance evaluation and management including verbal coaching and counseling. + Participating in the… more
- Trinity Health (Silver Spring, MD)
- …Aides and LPNs as needed. Provides therapeutic intervention, overall care management and achievement of top decile client outcomes and patient satisfaction. ... active involvement in quality improvement activities. + Provides ongoing care management oversight/activities to assigned patients to achieve high quality care,… more
- Fresenius Medical Center (Alexandria, VA)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …an Associate's Degree and a minimum of 2 years of experience in Utilization Management , Referral Management , Authorization/Denials, or Medical Claims ... Team Ivyhill is currently seeking to hire Referral Management (Non- Nurse ) Reviewers to support its contract with the Integrated Referral Management and… more
- Evolent (Washington, DC)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …nursing program. Must have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management (UM) experience is preferred. ... Ivyhill is currently seeking to hire Referral Management (RN) Training Manager to support its contract...all the duties and requirements of the Referral Registered Nurse and the the RM Reviewers. Requirements Qualified candidate… more
- Trinity Health (Silver Spring, MD)
- …position requires a minimum of two years of experience in Social Work Case Management within an acute care facility. Additional training to learn the role will not ... be provided.** **Are you an experienced Social Worker Case Management LMSW looking for premium compensation and maximum flexibility? Explore FirstChoice - Trinity… more
- Select Medical (Alexandria, VA)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- Select Medical (Alexandria, VA)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- Highmark Health (Washington, DC)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** + Working knowledge of… more
- Erickson Living (Springfield, VA)
- …tests. + Communicates with external health care facilities to support the EHWC nurse practitioner with claims management for work-related injuries. + Supports ... medical assistant tasks under the supervision of the EHWC Nurse Practitioner (NP). The employee health and well-being center...the EHWC NP with community outreach to drive elective utilization of the employee health and well-being center, such… more