- 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 (Clinton, MD)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Trinity Health (Silver Spring, MD)
- …Type:** Full time **Shift:** Day Shift **Description:** **Position Purpose:** As a Case Manager in Utilization Management, you will be the key to ensuring ... care plans to align with clinical and regulatory standards. By optimizing resource utilization and maintaining the highest standards of care, you will contribute to… more
- 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
- 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
- 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
- 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
- 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 (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
- 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