- Ascension Health (Baltimore, MD)
- …education, experience, location, qualifications and comparison with associates in similar roles_ ** Registered Nurse , Certified Case Manager (CCM, ACM, URAC) ... with your Talent Advisor for additional specifics._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing… more
- Baylor Scott & White Health (Annapolis, MD)
- …Note: Benefits may vary based on position type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff. You oversee ... Factors** + Demonstrable knowledge in discharge planning, case management, utilization review and different care levels. +...work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Amergis (Hunt Valley, MD)
- The Registered Nurse - Hospice Case Manager is responsible for providing care, comfort and support to terminally ill patients. The Registered Nurse - ... delivery of hospice patient care in various settings. The Registered Nurse demonstrates the ability to make...Responsibilities: + Will be operating in both a Case Manager Capacity and Hands-on Hospice care (Plan of care,… 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
- 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
- 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
- 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
- Amergis (Baltimore, MD)
- …weeks - staff's preference! Shift M-F 8-5:00pm! No weekends! Hours/Week? 40 The RN Case Manager is responsible for coordinatingcontinuum of care activities for ... + Documents patient case information within a database system + Performs chart review /audits monthly or as needed + Participates in monthly case conferences by… more
- 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
- 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
- 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 (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
- 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
- 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
- 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)
- …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
- 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)
- …and over- utilization by performing medical reviews via prepayment claims review and post-payment auditing. + Correlates review findings with appropriate ... ** Nurse Auditor Senior - Carelon Payment Integrity** **Location:**...responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by healthcare providers through prepayment… more