- Humana (Washington, DC)
- …in an adult learning environment **OR** one (1) or more years successfully working as a Utilization Management Nurse or BH Utilization Management ... first** Humana Healthy Horizons in Virginia is seeking a Learning Facilitator/Preceptor, Utilization Management (Learning Facilitation Professional 2 ) who… more
- Erickson Living (Silver Spring, MD)
- …Previous experience with electronic medical records is preferred. + A minimum of 2 years of staff management , including delegating, developing, coaching, and ... living and health care with campuses in 11 states-and growing. The Nurse Practitioner, Employee Health and Well-Being, under general supervision from the National… more
- Humana (Washington, DC)
- …ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, Durable ... caring community and help us put health first** The Compliance Professional 2 ensures compliance with governmental requirements. The Compliance Professional 2 … 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
- Prime Therapeutics (Washington, DC)
- …company achieving revenue goals and operational objectives. Responsible for executing utilization management programs on behalf of health plan/payor customers, ... clinical reviewer. + Practices and maintains the principles of utilization management by adhering to the company...cardholders, and pharmacies. + Escalates medical exception requests to nurse , pharmacist or physician on the utilization … more
- Sunrise Senior Living (Silver Spring, MD)
- …regulations. + A minimum of two ( 2 ) years' experience in a nurse management position within a skilled nursing environment including hiring staff, coaching, ... The Director of Nursing Services is responsible for providing leadership and management to the skilled nursing operations. Responsible for planning, organizing and… more
- Elevance Health (Washington, DC)
- …responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment ... + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and procedures. + Investigates potential… more
- Wellpath (Alexandria, VA)
- …the organization's Code of Conduct. + Demonstrates knowledge of risk management , clinical precautions, infection control, fall prevention, utilization of ... **Compensation Range** $107,995.68 - $119,995. 2 / year **You Matter** * Make a...+ Have and maintain current licensure as a Registered Nurse within the state of employment. + Obtain and… more
- VHC Health (Arlington, VA)
- …Preferred. Experience: 5 years Infection Prevention required; and, 3 years of management experience required; and 2 years Aseptic Technique preferred; and, ... or prevention of nosocomial infections and exposure to communicable diseases, through utilization of OSHA standards and CDC guidelines. This role involves developing… more
- CVS Health (Falls Church, VA)
- …collaborative position working proactively with the Aetna account team, Aetna's Care management teams, and key National and Enterprise account partners to support ... + Provide progressive consultative clinical insights based on analysis of clinical plan utilization and impact of member behavior on medical plan costs. + Recommend… more