- Ascension Health (Baltimore, MD)
- …the offer._ **Responsibilities** Provide health care services regarding admissions, case management , discharge planning and utilization review . ... **Details** + **Department:** Utilization Management + **Schedule:** Full-time, Day...and regulations. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Maryland Board… more
- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Fresenius Medical Center (Baltimore, MD)
- …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
- Highmark Health (Annapolis, MD)
- …Highmark Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... + Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN … more
- Veterans Affairs, Veterans Health Administration (Baltimore, MD)
- …ineligible to apply. Responsibilities Duties: Home Based Primary Care (HBPC) Outpatient Staff Registered Nurse ( RN ) is responsible for providing competent, ... their care within the HBPC Program. Responsible for case management , assessment, triage, Veteran education, resource coordination, medication and...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Humana (Annapolis, MD)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in the state of Virginia or ... licensure + Previous Medicare/Medicaid experience a plus + Previous experience in utilization management , case management , discharge planning and/or home… more
- System One (Baltimore, MD)
- …and behavioral health. Pay: $47.75/HR Hybrid- Baltimore, MD Must have one of the following: RN - Registered Nurse - State Licensure And/or Compact State ... ALTA IT Services is staffing a contract to hire opportunity for a Utilization Management Specialist to support a leading health insurance customer. The… more
- 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 ... functions, including but not limited to: Access Authorization and pre-certification, utilization review and denial management , CareCoordination,… more
- Humana (Annapolis, MD)
- …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… more
- CareFirst (Baltimore, MD)
- …5 years medical-surgical or similar clinical experience OR 5 years' experience in Medical Review , Utilization Management or Case Management at CareFirst ... organization or hospital. Demonstrated leadership skills. In Lieu of Education. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or… more
- Amergis (Columbia, MD)
- The Registered Nurse - Hospice Case Manager is responsible for providing care, comfort and support to terminally ill patients. The Registered Nurse - ... delivery of hospice patient care in various settings. The Registered Nurse demonstrates the ability to make...management of patient care. Position Details: + Position: RN Hospice Case Manager (Facility-Based) + Location: Howard County… more
- Erickson Living (Parkville, MD)
- …clinical leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management /Safety ... and processes in accordance with the Erickson Senior Living Management Policies and Procedures and nursing standards of practice....care, assisted living or hospital) is required. + Current Registered Nurse license for the state in… more
- Guardian Life (Annapolis, MD)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Sedgwick (Annapolis, MD)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **We are growing and looking for nurses who have their ... clinical data; to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers for Medicare &… more
- CareFirst (Baltimore, MD)
- …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... State Licensure RN - Registered Nurse in MD, VA orWashington, DC...Care Management , Home Health, Discharge Coordination and/or Utilization Review . **Preferred Qualifications:** + Knowledge and… more
- Johns Hopkins University (Baltimore, MD)
- …fluids with blood borne pathogens. **Minimum Qualifications** + Master's Degree in Nursing. + Registered Nurse license and Certified as a Nurse Practitioner. ... support in response to emergency situations. + Prepare chart documentation for review and counter signature by the physician. + Determine differential diagnosis. +… more