- BrightSpring Health Services (Greenbelt, MD)
- …prevention. Provide case management. Core Requirements + Deliver quality results through operational excellence, meeting daily/weekly/monthly/quarterly and annual ... Drive and deliver profitable growth Essential Job Responsibilities + Review daily appointment needs: packets completed and available to...accredited school of nursing OR License as a Registered Nurse , current and in good standing + Valid driver's… more
- Elevance Health (Hanover, MD)
- **Diagnosis Related Group Clinical Validation Auditor-** **Registered Nurse ** **Location:** This position will work a hybrid model ( remote and office). Ideal ... documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How you will make… more
- Highmark Health (Annapolis, MD)
- **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** **Fully Remote - Part Time - Weekends Required.** This job implements the effective utilization ... management strategies including: review of appropriateness of health care services, application of...a Health Coach/case management, and identification and resolution of quality issues. Monitors and analyzes the delivery of health… more
- GE Aerospace (Baltimore, MD)
- **Job Description Summary** Drive quality for assigned suppliers, including quality plan implementation. Select suppliers through qualification processes. Own ... market **Job Description** **Roles and Responsibilities** + Includes both Supplier Quality Assurance and Supplier Quality Development. Includes supplier… more
- Intermountain Health (Annapolis, MD)
- **Job Description:** The Pre-Access Prior Authorization RN provides timely review of authorization requests and/or review of denials to ensure medical necessity, ... payer policies, appeals and reconsideration needs. Promotes the quality and cost effectiveness of patient care using clinical acumen in preparation of documentation,… more
- Evolent (Annapolis, MD)
- …more than 70 plans and risk-bearing provider groups to better manage both the quality and cost of care. Through a comprehensive suite of resources-such as high-value ... rising cost of health care is unsustainable, and we believe every patient deserves higher quality care at lower costs. Founded in 2011, Evolent is a fast paced, high… more
- United Therapeutics (Annapolis, MD)
- …and collaborate with high level site staff with minimal supervision/escalation needed + Review the quality and integrity of clinical data via Source Document ... + Provide training to site staff as needed via onsite/ remote (phone or teleconference/web meeting) on protocol, study/vendor technology,... Review /Source Data Verification (SDR/SDV) to ensure assigned study sites'… more