- Ascension Health (Baltimore, MD)
- …options for post-discharge care. **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer ... time of hire. **Additional Preferences** + One year of **recent** experience in Utilization Management required. + Local and national travel options are… more
- Fresenius Medical Center (Washington, DC)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Reports changes in patient status regarding any clinical, insurance, or travel and transportation issues. STAFF: + Participates in the selection and hiring… more
- Humana (Annapolis, MD)
- …Standard Time **Required Qualifications** + Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a compact state with no disciplinary ... us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing...determination of the appropriate courses of action. As a Utilization Management RN working on the OneHome/Home… more
- Humana (Annapolis, MD)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...Greater than one year of clinical experience in a RN role in acute care setting with preference for… more
- CenterWell (Annapolis, MD)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... **Use your skills to make an impact** **Required Qualifications** + Active unrestricted RN license with the ability to obtain Compact Nursing License + A minimum… more
- CareFirst (Baltimore, MD)
- …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination of health… more
- Immigration and Customs Enforcement (Washington, DC)
- …Qualifications-Licenses and Certifications Required: a. Nursing License- Must be a Registered Nurse ( RN ).i. Maintains current/documented professional ... interpretation and/or translations services are available. d. The correctional registered nurse practices ethically per the Code...the DAD of Clinical Services when not on TDY travel . ii. Developing and communicating a strategic vision of… more
- Humana (Annapolis, MD)
- …**Use your skills to make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin, including compact license. + Two ... community and help us put health first** Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the… more
- CareFirst (Baltimore, MD)
- …Assignments are subject to change based on evolving business needs. **Licenses/Certifications** : RN - Registered Nurse - State Licensure And/or Compact ... Utilizing experience and skills in both care management and utilization management, the Onsite Clinical Navigator will leverage proficiency...State Licensure: RN - Registered Nurse in MD, VA or Washington,… more
- Deloitte (Washington, DC)
- …Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical ... (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, clinical documentation… more
- BrightSpring Health Services (Baltimore, MD)
- …in a Medicare certified home health agency generally required + Currently licensed as a Registered Nurse ( RN ), in good standing in state of residence ... clinical and operations leadership on survey preparation/chart reviews/staffing concerns/ED utilization and hospital admission reduction. + Provides survey management… more
- CareFirst (Baltimore, MD)
- …are subject to change based on evolving business needs. **Licenses/Certifications** : Health Services\ RN - Registered Nurse - State Licensure and/or Compact ... activities of Onsite Care Management staff, Onsite Clinical Navigators and/or other Registered Nursing roles embedded at a partnering hospital. This role will assist… more
- Highmark Health (Annapolis, MD)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...some actions or decisions **Language (Other than English):** None ** Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and… more