- Cognizant (Annapolis, MD)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… 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
- CareFirst (Baltimore, MD)
- …the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure. ... programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Clinical Utilization Management **Equal Employment Opportunity** CareFirst… more
- CVS Health (Annapolis, MD)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Evolent (Annapolis, MD)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- BAYADA Home Health Care (Towson, MD)
- …Living in **Pikesville / Towson, MD** **_._** Are you a solutions-oriented, team-focused ** Registered Nurse , Licensed Practical Nurse or Therapist (Physical ... members to deliver on our differentiated offerings. Through the utilization of outcome driven data analytics, this role will...professional growth. **Qualifications:** + Current MD licensure as a Registered Nurse , Licensed Practical Nurse ,… more
- CareFirst (Baltimore, MD)
- …& Qualifications** **PURPOSE:** The role of the Nurse , Quality Review Utilization Management (UM) is to evaluate clinical quality and procedures within ... work experience. **Licenses/Certifications Upon Hire Required:** + Health Services\RN - Registered Nurse - State Licensure and/or Compact State Licensure.… more
- Johns Hopkins University (Baltimore, MD)
- …and rapidly changing environment. **Minimum Qualifications** + Master's Degree in Nursing. + Registered Nurse license and Certified as a Nurse Practitioner. ... guidelines of the department and institution and in accordance with the Nurse Practitioner-Physician Written Agreement required and approved by the State of Maryland… more
- Johns Hopkins University (Baltimore, MD)
- …team while maintaining patient confidentiality. **Minimum Qualifications** + Master's Degree in nursing; Registered Nurse license and Certified as a Nurse ... consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and...process is required prior to start date_** Classified Title: Nurse Practitioner Job Posting Title (Working Title): Nurse… more
- Johns Hopkins University (Baltimore, MD)
- …team while maintaining patient confidentiality. **Minimum Qualifications** + Master's Degree in Nursing; Registered Nurse license and Certified as a Nurse ... to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast… 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. ... to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast… more
- CenterWell (Towson, MD)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... on-site at our Towson, MD branch location.** The **RN Clinical Manager** coordinates and oversees all direct care patient...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- BrightSpring Health Services (Baltimore, MD)
- …a Medicare certified home health agency generally required + Currently licensed as a Registered Nurse (RN), in good standing in state of residence (additional ... Health Services Overview Provide oversight, leadership and support relating to clinical practice and care provision. Consult and collaborate with agency leadership… more
- Deloitte (Baltimore, MD)
- …certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, ... or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical ...clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health… more
- Philips (Baltimore, MD)
- …imaging equipment etc) with clinical experience as Radiologic Technologist (RT) or Registered Nurse (RN) highly preferred. + Experience in healthcare (in the ... **Sales Support, Clinical Specialist - FORS (West/National Travel)** In this...to effectively manage assigned accounts in terms of driving utilization , customer relationship management, problem resolution, etc. + You… more
- Highmark Health (Annapolis, MD)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- CareFirst (Baltimore, MD)
- …High School Diploma or GED. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure RN- ... Registered Nurse in MD, VA or Washington,...experience working in Care Management, Discharge Coordination, Home Health, Utilization Review, Disease Management or other direct patient care… more
- CareFirst (Baltimore, MD)
- …**Education Level:** High School Diploma or GED **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact State Licensure RN- ... Registered Nurse in MD, VA or Washington,...experience working in Care Management, Discharge Coordination, Home Health, Utilization Review, Disease Management or other direct patient care… more