- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...to make an impact** **Required Qualifications** + Active licensed Registered Nurse (RN) in the state of… more
- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Utilization Management (UM) Nurse 2 RN utilizes clinical nursing skills to support ... skills to make an impact** **Required Qualifications** + Active Registered Nurse license in the state of...action + Minimum one, (1) year previous experience in utilization management + Minimum two, (2) years… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Humana (Washington, DC)
- …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… more
- Ivyhill Technologies LLC (Bethesda, MD)
- Ivyhill is currently seeking to hire a Registered Nurse (Non-Practicing) to support its contract with the Integrated Referral Management and Appointing ... services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for...have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management … more
- Humana (Annapolis, MD)
- …and help us put health first** The Compliance Nurse 2 reviews case management and utilization management activities and documentation to ensure adherence ... skills to make an impact** **Required Qualifications** + Active Registered Nurse license in the state of...clinical setting + Minimum three, (3) years of care management nursing experience + Intermediate to Advanced knowledge using… more
- Koniag Government Services (Camp Springs, MD)
- …LLC,** a Koniag Government Services company, is seeking a full time Occupational Health Registered Nurse to support **KPS** and our government customer in Camp ... score on the National Council Licensure Examination (NCLEX-RN) + Current active, unrestricted Registered Nurse license to practice in Maryland + Minimum of three… more
- Fresenius Medical Center (Clinton, MD)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Lanham, MD)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... by working with the Vice President of Quality and other organization management to ensure that organization/ASC policies and procedures are followed. + Responsible… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …+ Possession of current license or a multistate licensure privilege to practice as a Registered Nurse in the Commonwealth of Virginia. + Valid Driver's License + ... TB Field Public Health Nurse (Public Health Nurse II) Print...having TB disease or latent TB infection. Providing case management , TB health services, coordination of multidisciplinary services, and… more
- ZOLL Medical Corporation (Fairfax, VA)
- …+ High School Diploma or GED required. + Bachelor's Degree and/or Registered Nurse preferred. + Experience working with multidisciplinary healthcare teams ... assess workflows, synthesize findings, and recommend behavior changes to enhance HFMS utilization . + Partner with key stakeholders (Care Management , Nursing… more
- Molina Healthcare (Alexandria, VA)
- **JOB DESCRIPTION** For this position we are seeking a (RN) Registered Nurse or LCSW who lives in VIRGINIA and must be licensed for the state of VIRGINIA. ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …and able to perform all the duties and requirements of the Referral Registered Nurse and the the RM Reviewers. Requirements Qualified candidate must ... be a Licensed Registered Nurse (RN), with an unencumbered active...have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management … more
- BrightSpring Health Services (Arlington, VA)
- …+ Bachelor's Degree in Nursing or the equivalent + Currently licensed as a Registered Nurse (RN), in good standing in state of residence (additional state ... and direction in performance improvement, provision of clinical services, survey management , documentation management , incident management , EMR/EHR… more
- Sunrise Senior Living (Arlington, VA)
- …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 ... the highest quality standards for well-being. + Ensures proper utilization of the Resident Care Plan by all team...in a nurse management position within a skilled nursing… more
- Highmark Health (Washington, DC)
- …organizational systems **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + Registered Dietician + Registered Nurse **EDUCATION** **Required** ... clinical initiatives/programs to the customer audiences through effective project management , collaboration and application of best practices and engagement.… more
- Howard University Hospital (Washington, DC)
- …nursing experience 3+ years nursing leadership experience in a hospital setting Current Registered Nurse License for the District of Columbia BLS through ... placement of admitted patients. The incumbent assists in the formulation of a nurse float pool and coordinates the daily use of supplement staff. The incumbent… more
- Calvert Memorial Hospital (Prince Frederick, MD)
- …or bachelor's degree in a related field, preferred. + Registration/Certification/Licensure : + Registered Nurse (RN) License from State of Maryland or Compact ... JOB DESCRIPTION DETAILS + Job Summary : + Performs utilization review and discharge planning to patients through the...State preferred. Licensed Practical Nurse (LPN) License acceptable with case management … more
- Fresenius Medical Center (Silver Spring, MD)
- …under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization administrative… more
- Trinity Health (Silver Spring, MD)
- …Qualifications:** + Graduate of an approved Nursing education program, BSN preferred. + Current Registered Nurse licensure in the state of practice. + Must have ... Aides and LPNs as needed. Provides therapeutic intervention, overall care management and achievement of top decile client outcomes and patient satisfaction.… more