- Veterans Affairs, Veterans Health Administration (Baltimore, MD)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities Duties: Home Based Primary Care (HBPC) Outpatient Staff Registered Nurse (RN) is responsible for providing competent, evidence-based care to HBPC… more
- Cardinal Health (Annapolis, MD)
- …get life-changing therapies to patients who need them-faster.** **_Job Summary_** The Nurse , Individualized Care promotes high- quality patient care and treatment ... remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer...treatments of a small number of pharmaceutical clients, the Nurse receives inbound calls from patients and schedules outbound… more
- Humana (Annapolis, MD)
- …of our caring community and help us put health first** The Compliance Nurse 2 reviews case management and utilization management activities and documentation to ... and abuse to ensure appropriate course of action. The Compliance Nurse 2 understands department, segment, and organizational strategy and operating objectives,… more
- Humana (Annapolis, MD)
- …and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and ... and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and frequently require interpretation… more
- Humana (Annapolis, MD)
- …of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following ... services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and… more
- CareFirst (Baltimore, MD)
- …and claims to assist medical professional staff in performing the review of appeals and reconsiderations. Prioritize, research, analyze, and perform accurate ... Reviews, researches problematic correspondence and works on special projects with Appeals Nurse or Management. + Interacts regularly with and responds to internal… more
- Humana (Annapolis, MD)
- …experience (Med/Surg, ED, ICU preferred) + Inpatient and outpatient medical record review and auditing experience. **Workstyle:** Remote work at Home ... of our caring community and help us put health first** The Senior Quality Assurance Clinical Professional may assist with the development of policies, procedures,… more
- Humana (Annapolis, MD)
- …+ Certified or certified-eligible case manager required. **Additional Information:** **Workstyle:** Remote work at Home **Location for Registered Nurse :** must ... **Required Qualifications:** **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of Virginia or reside in a state… more
- Fujifilm (Annapolis, MD)
- …consulting for the project, report configuration (CV), workflow analysis, end-to-end testing, remote or onsite training as well as go-live support to Synapse PACS/MI ... of customers and company personnel in compliance with the company's quality procedures. Assist with TAC Support. **Company Overview** FUJIFILM Healthcare Americas… more
- Evolent (Annapolis, MD)
- …more than 70 plans and risk-bearing provider groups to better manage both the quality and cost of care. Through a comprehensive suite of resources-such as high-value ... rising cost of health care is unsustainable, and we believe every patient deserves higher quality care at lower costs. Founded in 2011, Evolent is a fast paced, high… more
- Gentiva (Windsor Mill, MD)
- …care for everyone, so we offer ongoing professional training, lower nurse -to-patient ratios, and comprehensive benefits for eligible employees. Here, you'll join ... as they apply to the provision of home visits to patients. **To quality for this position, you MUST be a Registered Nurse ( RN ), have a minimum of 2 years of of… more
- Cardinal Health (Annapolis, MD)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... of all program compliance activities, product training and adverse event/product quality complaint training. + Oversight of clinical training, coach, teach, train,… more
- Elevance Health (Hanover, MD)
- …Group Clinical Validation Auditor-RN** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50 miles of one of ... documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How you will make… more
- Cardinal Health (Annapolis, MD)
- …in problem-solving, research and problem/dispute resolution. **Shift:** Monday-Friday 8:30am-5:00pm EST ** Remote Details:** You will work from home, full-time. _As a ... in placing orders, obtain missing information to process, inform nurse of a change or delay in the order...environmentin a large team setting + Abide by the Quality Assurance Goals that are in place **Anticipated hourly… more
- Humana (Annapolis, MD)
- …related to Long-Term Services and Supports (LTSS). + Experience compiling NCQA File Review Universes. + Registered Nurse or Behavioral Health professional. + ... member PHI / HIPAA information. **Additional Information:** + **Workstyle:** Remote - work at home. + **Location:** Nationwide United...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families,… more
- CAI (Annapolis, MD)
- **Job ID Number** R4655 **Employment Type** Full time **Worksite Flexibility** Remote **Job Summary** We are looking for a motivated Case Manager, RN ready to take ... State and Federal requirements related to privacy practices, HIPAA, and quality performance standards + Perform other duties as assigned/requested **What You'll… more