• RN Manager - Utilization

    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
    Ascension Health (12/17/24)
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  • Dialysis Clinical Manager Registered

    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
    Fresenius Medical Center (12/31/24)
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  • Acute Inpatient Charge Registered

    Fresenius Medical Center (Columbia, MD)
    …of time, and for specific additional duties, as assigned by the Program Manager . The Inpatient Services Charge Nurse ensures appropriate provision of Acute ... **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the...their direct supervision and submit results to the Program Manager for review . + Ensure all Acute… more
    Fresenius Medical Center (12/31/24)
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  • RN Hospice Case Manager

    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
    Amergis (12/30/24)
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  • RN Manager -Post Acute Services

    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
    Ascension Health (11/06/24)
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  • Referral Management ( RN ) Traning…

    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
    Ivyhill Technologies LLC (12/10/24)
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  • Clinical Manager RN

    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
    Erickson Living (11/01/24)
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  • Clinical Appeals Manager - RN

    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 (11/09/24)
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  • RN Hospice Case Manager

    Amergis (Baltimore, MD)
    Amergis Staffing iscurrently seeking experienced Registered Nurses ( RN ) for Case Manager assignments in Baltimore City, MD! Position Details: Contract ... day Position Requirements: + Minimum 1 year of home-based RN Case Manager experience + Home Health...for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers… more
    Amergis (12/05/24)
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  • Utilization Management Nurse

    Elevance Health (Washington, DC)
    The Utilization Management Nurse is responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member ... but are not limited to: + Conducts pre-certification, continued stay review , care coordination, or discharge planning for appropriateness of treatment setting… more
    Elevance Health (12/24/24)
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  • Clinical Appeals Supervisor - RN (Hybrid)

    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
    CareFirst (11/09/24)
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  • RN Case Manager

    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
    Erickson Living (10/15/24)
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  • Clinical RN Comp Care - Remote

    Sharecare (Annapolis, MD)
    …support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... according to the disease management program intervention guidelines. An RN is supervised by an Operations Manager ...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
    Sharecare (12/17/24)
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  • Assistant Director of Nursing - RN

    Erickson Living (Catonsville, MD)
    …and dehydration. + Participating in Wound Rounds, Operations Meetings, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) ... and survey readiness. **What you will need** + Current RN nursing license with no restrictions for the state...3 years' experience in a healthcare leadership role (Charge Nurse , Unit Manager , etc.). + Experience with… more
    Erickson Living (11/07/24)
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  • Care Manager (Remote)

    CareFirst (Baltimore, MD)
    …**Education Level:** 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… more
    CareFirst (11/22/24)
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  • Care Manager (Remote)

    CareFirst (Baltimore, MD)
    …**Education Level:** High School Diploma or GED. **Licenses/Certifications:** + **Upon Hire Required:** RN - Registered Nurse - Compact State Licensure ... RN - Registered Nurse in MD, VA, and/or State Licensure in Washington,...experience working in Care Management, Discharge Coordination, Home Health, Utilization Review , Disease Management or other direct… more
    CareFirst (12/19/24)
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  • CO Clinical Nurse Manager

    Johns Hopkins University (Lutherville, MD)
    The Department of Otolaryngology is seeking a **_CO_** **_Clinical Nurse Manager_** the Clinical Nurse Manager collaborates with the Medical Director and ... and development. In partnership with the Clinic Supervisor, the Nurse Manager provides oversight to the clinical...Nursing or related field. + Individual must be a registered nurse , licensed in the State of… more
    Johns Hopkins University (10/31/24)
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  • Care Manager Behavioral Health - Part Time…

    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
    Highmark Health (12/12/24)
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  • CO Research Nurse Manager

    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
    Johns Hopkins University (12/19/24)
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  • Clinical Appeals Nurse (Remote)

    CareFirst (Baltimore, MD)
    …complications. **QUALIFICATIONS:** **Education Level:** High School Diploma or GED. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure ... Manager Upon Hire Preferred + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred **Experience:** 2 years...setting. **Preferred Qualifications:** + 2 years' experience in Medical Review , Utilization Management or Case Management at… more
    CareFirst (11/09/24)
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