- One Medical (Washington, DC)
- …care services, on-site labs, and programs for preventive care, chronic care management , common illnesses and mental health concerns have been delighting people for ... collaboration with both virtual and in-office teammates via daily huddles Utilization of your specific clinical training and opportunities to give exceptional… more
- Humana (Annapolis, MD)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Annapolis, MD)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- CenterWell (Annapolis, MD)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...3 years of diverse clinical experience as a Registered Nurse in an Intensive Care Unit (ICU), Emergency Department… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... of business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption… more
- Ascension Health (Baltimore, MD)
- …time of hire. **Additional Preferences** + One year of **recent** experience in Utilization Management required. + Local and national travel options are ... for post-discharge care. **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer date required. +… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …to patient groups, maximizing utilization of resources, and enhancing the case management program. The nurse 's primary commitment is to the patient, whether ... Summary The Psychosocial Rehabilitation and Recovery Center Nurse role is to collaboratively manage, coordinate and provide health care to a defined group of… more
- Johns Hopkins University (Baltimore, MD)
- …guidelines of the department and institution and in accordance with the Nurse Practitioner-Physician Written Agreement required and approved by the State of Maryland ... and the Nurse Practice Act of the State of Maryland. Is...long-term effects of radiation and provides accurate and timely management for such side effects. + Provides education to… more
- CVS Health (Annapolis, MD)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Elevance Health (Hanover, MD)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... ** Nurse Reviewer I** **Virtual:** This role enables associates...required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …and analysis for the purpose of improving care to patient groups, maximizing utilization of resources and enhancing the case management program. Adhere to ... Summary The Intensive Community Mental Health Program (ICMHR) Registered Nurse (RN) is a member of the Behavioral Health Care Service Line whose role is to… more
- Immigration and Customs Enforcement (Washington, DC)
- …health facility surveyors and in collaboration with the IHSC Medical Quality Management Unit. SUPERVISORY CONTROLS: The Clinical Senior Nurse Specialist, Medical ... clinical and administrative nursing support, and collaborating with the IHSC Chief Nurse in the Nursing Services Unit to implement initiatives aimed at enhancing… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- Summary The Same Day Procedure Unit (SDPU) Registered Nurse (RN) provides care to patients prior to and immediately after various surgeries and procedures. The SDPU ... care duties such as physical assessment, obtaining labs, obtaining EKG, management of belongings, confirming consent, history and physical. Responsibilities The Same… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- Summary The primary purpose of the Registered Nurse - Primary Care/CBOC Case Manager position is to demonstrate leadership in delivering and improving holistic care ... for patient's health care options and services. Responsibilities The Registered Nurse is responsible for providing competent, evidence-based care to assigned… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …nursing program. Must have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management (UM) experience is preferred. ... Ivyhill is currently seeking to hire a Registered Nurse (Non-Practicing) to support its contract with the Integrated Referral Management and Appointing Center… more
- Johns Hopkins University (Baltimore, MD)
- …to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast of ... and informal policies, procedures and practices necessary to facilitate safe and effective management of acute and chronic illness in patients presenting in the ED.… more
- Johns Hopkins University (Baltimore, MD)
- The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for ... to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast of… more
- Johns Hopkins University (Baltimore, MD)
- The Department of Emergency Medicine is seeking a **_Sr. Nurse Practitioner_** to work collaboratively within a multidisciplinary health care team. Responsible for ... to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast of… more
