• Dialysis Program Manager

    Fresenius Medical Center (Baltimore, MD)
    **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
    Fresenius Medical Center (03/04/25)
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  • Manager , Utilization Management…

    Humana (Annapolis, MD)
    …**Required Qualifications:** **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of Virginia or reside ... manager required. **Additional Information:** **Workstyle:** Remote work at Home **Location for Registered Nurse :** must reside in the state of Virginia or… more
    Humana (03/12/25)
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  • RN Hospice Case Manager

    Amergis (Columbia, MD)
    The Registered Nurse - Hospice Case Manager is responsible for providing care, comfort and supportto terminally ill patients. The Registered Nurse - ... the delivery of hospice patient carein various settings. The Registered Nurse demonstrates the abilityto make clinical...in the managementof patient care. Position Details: + Position: RN Hospice Case Manager (Facility-Based) + Location:… more
    Amergis (03/04/25)
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  • Population Health Nurse ( RN

    Ascension Health (Baltimore, MD)
    …and salary range at the time of the offer._ **Responsibilities** Manage assigned Registered Nurse ( RN ) case managers, related activities and workflow ... including but not limited to: Access Authorization and pre-certification, utilization review and denial management, CareCoordination, Collaborative treatment… more
    Ascension Health (02/04/25)
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  • Care Manager RN (Delaware) Remote

    Highmark Health (Annapolis, MD)
    …+ Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN ... Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health… more
    Highmark Health (02/20/25)
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  • RN Clinical Manager

    Erickson Living (Parkville, MD)
    …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... Relocation assistance potential.** Join our team as the Clinical Manager is an active member of the clinical leadership...care, assisted living or hospital) is required. + Current Registered Nurse license for the state in… more
    Erickson Living (01/21/25)
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  • Clinical Appeals Supervisor (Hybrid)

    CareFirst (Baltimore, MD)
    …organization or hospital. Demonstrated leadership skills. In Lieu of Education. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or ... similar clinical experience OR 5 years' experience in Medical Review , Utilization Management or Case Management at...Manager Upon Hire Preferred + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred **Preferred Qualifications:** +… more
    CareFirst (03/04/25)
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  • Clinical Appeals Nurse (Remote)

    CareFirst (Baltimore, MD)
    …treatment needs or those with substance disorders and addictions. **Licenses/Certifications** : + RN - Registered Nurse - State Licensure And/or Compact ... **Preferred Qualifications** : + 2 years experience in Medical Review , Utilization Management or Case Management at...Manager Upon Hire Preferred + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred Salary Range: $66,960… more
    CareFirst (02/15/25)
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  • Nurse Audit Sr

    Elevance Health (Hanover, MD)
    …fraud and over- utilization by performing medical reviews via prepayment claims review and post payment auditing. + Correlates review findings with ... ** Nurse Audit Sr** **Location:** This position will work...responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through… more
    Elevance Health (03/15/25)
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