- Evolent Health (Annapolis, MD)
- …resolutions, driving results, and collaborating with others. **Collaboration Opportunities** : The Lead Nurse of Utilization Management is responsible for ... 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
- Trinity Health (Silver Spring, MD)
- …closely related area. + Extensive knowledge of payer mechanisms and clinical utilization management is required. + Knowledge of pertinent regulatory, ... **Employment Type:** Full time **Shift:** **Description:** The Manager-Care Management & Utilization Review, under the supervision and in collaboration with the… more
- Trinity Health (Silver Spring, MD)
- …acute healthcare setting required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At least 5-7 years ... - 4:30pm + Reporting to the Director of Care Management + The RN Manager is responsible and accountable...RN Case Managers for in inpatient care coordination and utilization review. Oversees interactions of staff with outside activities… more
- CVS Health (Annapolis, MD)
- …health care more personal, convenient and affordable. **Position Summary** The Lead Director of Observability Governance is responsible for leading strategic ... standards to meet the needs of all CVS Health businesses. As a Lead Director of Observability Governance, you will collaborate with observability engineering and… more
- Guidehouse (Baltimore, MD)
- …You Will Do** **:** We are seeking a highly skilled and strategic Functional Lead specializing in ERP Procurement and Sourcing. This role is pivotal in leading the ... requirements gathering, and future state definition of a large client's financial management system modernization as a Procurement function subject matter expert. +… more
- Humana (Annapolis, MD)
- …for key Medicaid programs and subpopulations. Areas of focus include Care Management , Quality Improvement, Utilization Management , Population Health, Social ... health first** Humana Healthy Horizons is seeking a Capture Lead , Clinical & Population Health Strategy, to lead...health of the communities it serves. The **Medicaid Capture Management ** team's purpose is to successfully position Humana to… 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 ... eliminate and prevent unnecessary medical-expense spending. The **RN Hospital Audit/Appeal Lead ** is responsible for leading a team of clinicians responsible for… more
- Humana (Annapolis, MD)
- …+ Develop and implement strategies to enhance program efficiency, ensuring optimal utilization of resources. + **Description Management :** + Oversee the ... first** The Medicaid Long-Term Supports and Services (LTSS) Process Improvement Lead analyzes and measures the effectiveness of existing business processes and… more
- Humana (Annapolis, MD)
- …a part of our caring community and help us put health first** The Lead Cloud Solutions Engineer (Network) is responsible for the planning, design, and engineering of ... infrastructure and platforms related to cloud network & cloud computing. The Lead Cloud Solutions Engineer (Network) provides strategic advice and guidance to… more
- Merck (Annapolis, MD)
- …for this hybrid position will have responsibilities as both an Institutional Account Lead (IAL) and Payer Account Executive within the assigned geography and for ... but are not limited to the following:** The IAL Hybrid Institutional Account Lead / Payer Account Executive will manage the business relationship between our Company… more
- The Cigna Group (Baltimore, MD)
- **Role Summary** The Provider Performance Enablement Lead Analyst is a key member of the market that assists in the growth and development of the provider network. ... that represents Cigna Medicare Advantage. The Provider Performance Enablement Lead Analyst's responsibilities include: + Most likely to have responsibility… more
- CACI International (Fort Meade, MD)
- Portfolio Lead Job Category: Project and Program Management Time Type: Full time Minimum Clearance Required to Start: TS/SCI with Polygraph Employee Type: ... **CACI** is seeking a motivated leader for a **Portfolio Lead ** opportunity in the Fort Meade, Maryland area. This...of a portfolio of Technical Task Orders (TTOs) and management of all personnel supporting those TTOs. You will… more
- ManTech (Hanover, MD)
- …for advancement. Currently, ManTech is seeking a motivated, career and customer-oriented ** Lead CNO Developer Test Engineer** to join our team in Hanover, MD. ... include, but are not limited to:** + As a Lead CNO Developer Test Engineer, you will work in...be able to effectively communicate with the technical team, management , and customer to keep them informed of progress,… more
- ManTech (Hanover, MD)
- …Nation, Ignite your Future** ManTech is currently looking for a proactive and ambitious ** Lead Embedded CNO Developer** to join our team in **Hanover, MD** . As a ... include, but are not limited to:** + As a Lead CNO Developer, you will work in an Agile...be able to effectively communicate with the technical team, management , and the customer to keep them informed of… more
- BigBear.ai (Columbia, MD)
- …enterprise architecture. Tasks will include providing system engineering, configuration management , deployment management , planning, scheduling, and related ... throughout the systems life cycle phases: Concept, Development, Production, Utilization , Support, and Retirement Interacts with the Government regarding Systems… more
- WellSpan Health (York, PA)
- …Responsibilities Essential Functions: + Reviews assigned patients for medical necessity, utilization management , and appropriateness of setting for continued ... quality and cost of care efforts. + Liaisons between utilization management team, third party payers, and...the impact of medical errors and methodology that will lead to reduction of errors; reporting actual and potential… more
- GAF (Columbia, MD)
- …a financial budget, strategic project execution (fleet growth) regulatory compliance, and utilization metrics. The Director of Asset Management will create a ... service lease to a hybrid (majority owned) fleet. + Lead the asset utilization drive and work...or 10+ years of experience in asset lifecycle, maintenance management and asset utilization leadership + 7+… more
- WellSpan Health (Gettysburg, PA)
- …data analysis as required. + Develops and initiates educational programs regarding utilization management principles. + Attends meetings as required. Required ... the impact of medical errors and methodology that will lead to reduction of errors; reporting actual and potential...acute care experience. Required + Field of experience in Utilization management , case management or… more
- National Archives and Records Administration (College Park, MD)
- …with all relevant laws, regulations, and government policies, and ensure data integrity. Lead the implementation of an Enterprise Risk Management (ERM) system, ... of the National Archives and Records Administration, Office of the Chief of Management & Administration. The incumbent will serve as the principal advisor to the… more
- Evolent Health (Annapolis, MD)
- …with others. **Collaboration Opportunities:** + The Manager, Client Services oversees daily utilization management and directs the medical care of our members ... in a supporting role to the Director, Intake and Utilization Management Operations. + This individual will...Management Operations. + This individual will not only lead a production team but will also work closely… more