- Humana (Annapolis, MD)
- …help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Annapolis, MD)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- CVS Health (Annapolis, MD)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- CenterWell (Annapolis, MD)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CareFirst (Baltimore, MD)
- …programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Clinical Utilization Management **Equal Employment ... **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination… more
- Evolent (Annapolis, MD)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- BAYADA Home Health Care (Towson, MD)
- …/ Towson, MD** **_._** Are you a solutions-oriented, team-focused **Registered Nurse , Licensed Practical Nurse or Therapist (Physical Therapist, Occupational ... create alignment to common goals across multiple levels of management ? Would you like to be viewed as a...members to deliver on our differentiated offerings. Through the utilization of outcome driven data analytics, this role will… more
- Fresenius Medical Center (Towson, MD)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Johns Hopkins University (Baltimore, MD)
- …guidelines of the department and institution and in accordance with the Nurse Practitioner-Physician Written Agreement required and approved by the State of Maryland ... and the Nurse Practice Act of the State of Maryland. Is...long-term effects of radiation and provides accurate and timely management for such side effects. + Provides education to… more
- CVS Health (Annapolis, MD)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... self-insured clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures… more
- Johns Hopkins University (Baltimore, MD)
- …to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast ... The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for… more
- Johns Hopkins University (Baltimore, MD)
- …to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast ... to plan patient care. + Responsible for the conduct of EM sponsored clinical trials including regulatory issues, recruitment and good clinical practice.… more
- Johns Hopkins University (Baltimore, MD)
- …to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast ... The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for… more
- Johns Hopkins University (Baltimore, MD)
- …to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast ... The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for… more
- CareFirst (Baltimore, MD)
- …of care. Utilizing experience and skills in both care management and utilization management , the Onsite Clinical Navigator will leverage proficiency in ... **Resp & Qualifications** **PURPOSE:** The Inpatient Management Onsite Clinical Navigator (RN) embedded at a partnering hospital will conduct concurrent review… more
- BrightSpring Health Services (Baltimore, MD)
- …delivery. Provides o versight and direction in performance improvement, provision of clinical services, survey management , documentation management , incident ... management , EMR/EHR application, training and education of clinical leadership and staff. Responsibilities + Monitors and recommends process improvements based… more
- Deloitte (Baltimore, MD)
- … registered nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG ... and informal education of physicians, CDI team, health information management and other clinical staff + Develop...medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical … more
- CareFirst (Baltimore, MD)
- …FUNCTIONS:** + Provides direct onsite supervision, mentorship and support to care management staff, clinical navigators and other CareFirst nursing staff working ... - State Licensure and/or Compact State Licensure. **Experience:** 3 years Care Management , Discharge Coordination, Home Health, Utilization Review, Disease … more
- University of Maryland, Baltimore (Baltimore, MD)
- …audits. 2. Directs activities related to the delivery of medical care and clinical services such utilization review, quality assurance, policies, procedures and ... managed by University of Maryland Medical Center (UMMC). 8. Provides oversight of utilization and risk management activities including monitoring of service … more
- ZOLL Medical Corporation (Baltimore, MD)
- …relevant clinical , reporting, and technical information that supports the utilization of ZOLL Cardiac Diagnostic products for appropriate patients. + Responsible ... patients suffering from serious cardiopulmonary and respiratory conditions.ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed… more