- 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 ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- Humana (Annapolis, MD)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination,… more
- Humana (Annapolis, MD)
- …put health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management (Behavioral Health) who will utilize their clinical skills to ... behavioral health services and/or benefit administration determinations. The Manager, Utilization Management (Behavioral Health) applies a Person-Centered… more
- Humana (Annapolis, MD)
- …of leadership experience. + Minimum two ( 2 ) years of experience in utilization management . + Prior clinical experience preferably in skilled acute care ... Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management Nursing who will use their...to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the commonwealth of Virginia, with no… more
- Humana (Annapolis, MD)
- …community and help us put health first** Humana Healthy Horizons is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
- Humana (Annapolis, MD)
- …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
- Humana (Annapolis, MD)
- …services, social sciences, or health related field. + Previous experience in utilization management , discharge planning and/or home health or rehabilitation. + ... TN & NC)_ **.** + An active, unrestricted, Registered Nurse (RN) license or Licensed Mental Health Professional (LMHP)...complex populations or in manage care settings. + Two ( 2 ) or more years of management or… more
- Elevance Health (Hanover, MD)
- …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
- Humana (Annapolis, MD)
- …in analyzing and interpreting financial trends. + Previous experience in utilization management , discharge planning and/or home health or rehabilitation. ... complex populations or in manage care settings. + Two ( 2 ) or more years of management or...human services, social sciences, or health-related field. + Care Management certification (CCM). + Active, unrestricted, Registered Nurse… more