- Ascension Health (Baltimore, MD)
- …education, experience, location, qualifications and comparison with associates in similar roles_ ** Registered Nurse , Certified Case Manager (CCM, ACM, URAC) ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
- 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
- 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)
- …Connect with your Talent Advisor for additional specifics._ **Responsibilities** Manage assigned Registered Nurse ( RN ) case managers, related activities and ... including but not limited to: Access Authorization and pre-certification, utilization review and denial management, CareCoordination, Collaborative treatment… more
- Ivyhill Technologies LLC (Bethesda, MD)
- … Nurse and the the RM Reviewers. Requirements Qualified candidate must be a Licensed Registered Nurse ( RN ), with an unencumbered active RN license ... Ivyhill is currently seeking to hire Referral Management ( RN ) Training Manager to support its...all incoming RM staff to be able to accurately review referrals utilizing the Specialty Referral Guideline (SRG) compliance… more
- CareFirst (Baltimore, MD)
- …care, and experience reviewing patient medical care Demonstrated leadership skills. **Licenses/Certifications** RN - Registered Nurse - State Licensure ... standards and federal/state regulations and general principles relating to utilization review .Computer skills, including Microsoft Office programs. +… more
- Erickson Living (Parkville, MD)
- …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... Relocation assistance potential. Join our team as the Clinical Manager is an active member of the clinical leadership...care, assisted living or hospital) is required. + Current Registered Nurse license for the state in… more
- CareFirst (Baltimore, MD)
- …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... with dynamic goals resulting in the full and fair review of appeals and designed to achieve corporate objectives...+ Master's in Science Nursing or related field, Legal Nurse Consultant, Utilization Management, and Government Program… more
- CareFirst (Baltimore, MD)
- …people. **QUAIFICATIONS:** **Education Level:** High School Diploma or GED. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or ... Manager Upon Hire Preferred. + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred. **Experience:** + 5...clinical experience OR + 5 years experience in Medical Review , Utilization Management or Case Management at… more
- Highmark Health (Annapolis, MD)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
- Erickson Living (Silver Spring, MD)
- …of medical practice; insurance benefit structures and related legal/medical issues; and utilization review and quality assurance procedures. Please note that ... consecutive year!_** Join our 5-star rated team as a RN Case Manager (also known as Care...+ Researches and selects care options as appropriate. The nurse care coordinator may utilize a range of alternative,… more
- Highmark Health (Annapolis, MD)
- …+ Licensed Marriage and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** + Working knowledge of ... Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care… more
- BAYADA Home Health Care (Gaithersburg, MD)
- **BAYADA Home Health Care** is seeking a full-time ** Registered Nurse ( RN ),** **Physical Therapist (PT), Occupational Therapist (OT) or Speech Language ... and dynamic environment, we offer exciting career paths. **The RN , PT, OT, or SLP Rehab Manager ...including OASIS and care plan coding + Monitor episodic utilization + Act as internal case manager … more
- Johns Hopkins University (Baltimore, MD)
- …Cancer (UAD) Program and the Director of Clinical Research Administration. The Research Nurse Manager will be responsible for the overall management of the ... as needed. **Minimum Qualifications** + Individual must be a registered nurse , licensed in the State of...in nature and level of difficulty. Classified Title: Research Nurse Manager Job Posting Title (Working Title):… more
- CareFirst (Baltimore, MD)
- …clinical experience OR 3 years' experience in mental health, psychiatric setting. **Licenses/Certifications** RN - Registered Nurse - State Licensure And/or ... State Licensure Upon Hire Required CCM - Certified Case Manager Upon Hire Preferred LNCC - Legal Nurse...Preferred **Preferred Qualifications:** + 2 years' experience in Medical Review , Utilization Management or Case Management at… more
- Elevance Health (Hanover, MD)
- **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
- United Therapeutics (Annapolis, MD)
- …Degree preferably in a health, biological sciences, or related field or + Registered Nurse ( RN ) nursing qualifications or relevant clinical research ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… more
- Elevance Health (Hanover, MD)
- …Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. + Partners ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more