- Trinity Health (Silver Spring, MD)
- …management or related field, with 2+ years in a leadership role in case management , utilization review , or similar areas. + Extensive understanding of ... of hospital staff in inpatient care coordination, social work, utilization review , and discharge planning. + Collaborate...payer mechanisms and clinical utilization management . + Strong interpersonal skills with… more
- Fresenius Medical Center (Alexandria, VA)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Humana (Arlington, VA)
- …supports the goal to put health first? The Prior Authorization, Registered Nurse , RN , Intern will review prior authorization requests for appropriate ... onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN , Intern will...experience a plus. + Previous experience in prior authorization, utilization management + Experience working with MCG… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …management services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for timely review of Right of First ... RM Team. Requirements Qualified candidate must be a Licensed Registered Nurse ( RN ), with an...have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management … more
- Highmark Health (Washington, DC)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… 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. ... integrated) performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical… more
- Ivyhill Technologies LLC (Bethesda, MD)
- … Nurse and the the RM Reviewers. Requirements Qualified candidate must be a Licensed Registered Nurse ( RN ), with an unencumbered active RN license ... Ivyhill is currently seeking to hire Referral Management ( RN ) Training Manager to support...have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management … more
- BAYADA Home Health Care (Gaithersburg, MD)
- **BAYADA Home Health Care** is seeking a full-time ** Registered Nurse ( RN ),** **Physical Therapist (PT), Occupational Therapist (OT) or Speech Language ... and procedures. Rehab Managers are also accountable for internal case management , field staff evaluation and development. The successful Physical Therapist,… more
- Sharecare (Washington, DC)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... members of the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager. All Sharecare clinicians… more
- Cardinal Health (Washington, DC)
- …and service education to facilitate technology adoption and workflow change management . + Demonstrates extensive knowledge and understanding of relevant clinical ... best demonstrated practices + Significantly influences customer acceptance and utilization of new products and services in multi-site and/or...of the time + Bachelor's degree preferred + Current RN license preferred + 6-8 years of experience in… more
- Fresenius Medical Center (Alexandria, VA)
- …dialysis clinic. You will collaborate with the Medical Director and the Charge Nurse regarding the provision of quality patient care in the dialysis clinic. ... data collections and auditing activities. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review… more