- Evolent Health (Annapolis, MD)
- …results, and collaborating with others. **Collaboration Opportunities** : The Lead Nurse of Utilization Management is responsible for assisting the ... UM Manager in supervising the operational productivity of the Utilization Management nurses by implementing and maintaining...flow of information through the UM department. The UM Lead , in collaboration with the UM Manager and Director,… more
- Fresenius Medical Center (Towson, MD)
- …As a Clinical Manager, you may advance your career into an Area Team Lead or Director of Operations role. **Our culture:** We believe our employees are our ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
- Elevance Health (Hanover, MD)
- ** RN Hospital Bill Audit/Appeal Lead ** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model (remote and ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** RN Hospital Audit/Appeal Lead ** is responsible for leading a team… more
- CareFirst (Baltimore, MD)
- …Executive Vice President, Health Services, this position leads and oversees Case Management , Utilization Management including prior authorization, and post ... and medical care management at all stages of the health continuum, utilization management decisions themselves and the consequences of those decisions by way… more
- Elevance Health (Hanover, MD)
- …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Woodlawn, MD)
- …requirements:** + Requires minimum of 3 years acute care clinical experience or case management , utilization management or managed care experience; or any ... ** Nurse Medical Management II** **Location: multiple...provide an equivalent background. + Requires current active unrestricted RN license to practice as a health professional in… more
- Elevance Health (Hanover, MD)
- …management plan and modifies as necessary. + Assists with development of utilization /care management policies and procedures. + Participates in or leads ... with healthcare providers and/or consumer to drive personalized health management and improve health outcomes for optimal consumers. Performs...experience and a minimum of 1 year in a Nurse Care Mgr I role or equivalent experience; or… more