- Ivyhill Technologies LLC (Bethesda, MD)
- Ivyhill is currently seeking to hire a Registered Nurse (Non-Practicing) to support its contract with the Integrated Referral Management and Appointing Center ... referral management services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for timely review of Right of First… more
- University of Virginia (Haymarket, VA)
- …the healthcare team to promote and adhere to regulatory compliance. The UM RN conducts initial concurrent and retrospective medical necessity reviews. All ... + Demonstrates competence in interpretation of clinical data and the application of UM tools Collaborates with physicians and care team: Attending resident and mid… more
- University of Virginia (Haymarket, VA)
- …the healthcare team to promote and adhere to regulatory compliance. The UM RN conducts initial concurrent and retrospective medical necessity reviews. All ... + Demonstrates competence in interpretation of clinical data, and the application of UM tools. + Collaborates with physicians and care team: Attending, resident, mid… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …and able to perform all the duties and requirements of the Referral Registered Nurse and the the RM Reviewers. Requirements Qualified candidate must be a Licensed ... Registered Nurse (RN), with an unencumbered active RN license from...clinical nursing experience. Referral Management (RM) and Utilization Management ( UM ) experience is preferred. Full-time employment in a nursing… more
- Humana (Washington, DC)
- …strategy and/or HealthPlan operations + Professional clinical license (eg, MD, Registered Nurse or Pharmacist) or advanced degree such as Masters degree or higher ... medical coding and medical claims. + Experience with how utilization management ( UM ) and regulatory guidance can influence clinical strategies. + Highly creative and… more