- Trinity Health (Silver Spring, MD)
- …activities of RN Case Managers for in inpatient care coordination and utilization review . Oversees interactions of staff with outside activities and agencies ... will need:** + State of Maryland license as a Registered Nurse + BSN required; MSN Degree...required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At… more
- Fresenius Medical Center (Silver Spring, MD)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Highmark Health (Washington, DC)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements the effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Humana (Washington, DC)
- …hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse ( RN ) Credentials + Home Health, ... Durable Medical Equipment, and/or Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)… more
- HCA Healthcare (Reston, VA)
- … for all payers and maintains legible documentation as directed by the Utilization Management Plan.** **Educates patients and families to the patient's needs ... you passionate about delivering patient-centered care?** Submit your application for RN Case Management position and spend more time at the bedside with the… more
- Elevance Health (Washington, DC)
- …**How you will make an impact:** + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and ... **Anticipated End Date:** 2024-09-16 **Position Title:** RN Hospital Bill Audit/Appeal Lead **Job Description:** **...Management Exempt **Workshift:** **Job Family:** MED > Licensed Nurse Please be advised that Elevance Health only accepts… more
- Lincoln Financial Group (Washington, DC)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information...looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license… more
- Johns Hopkins University (Washington, DC)
- …team while maintaining patient confidentiality. + Technical Qualifications or Specialized Certifications + Registered Nurse license and Certified as a Nurse ... response to emergency situations. + Prepare chart documentation for review and counter signature by the physician. + Determine...pathogens. **Minimum Qualifications** + Master's Degree in Nursing. + Registered Nurse license and Certified as a… more
- Sunrise Senior Living (Arlington, VA)
- …of approved college / school of nursing + Maintains a current state license as a Registered Nurse per state regulations. + A minimum of two (2) years' experience ... the highest quality standards for well-being. + Ensures proper utilization of the Resident Care Plan by all team...in a nurse management position within a skilled nursing… more
- Elevance Health (Ashburn, VA)
- …equivalent and a minimum of 3 years acute care clinical experience or case management , utilization management or managed care experience; or any combination ... **Anticipated End Date:** 2024-12-27 **Position Title:** Nurse Medical Management II **Job Description:** **Location** : This position can be located anywhere… more
- Sharecare, Inc. (Washington, DC)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... members of the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager. All Sharecare clinicians… more