• 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 ... and minimum of 2 years acute care clinical experience. + Minimum 1 year Utilization Management experience preferred. For candidates working in person or remotely… more
    Elevance Health (09/24/24)
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  • Consultant, Nurse Disability

    Lincoln Financial Group (Washington, DC)
    …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
    Lincoln Financial Group (10/16/24)
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  • Utilization Management Director…

    CareFirst (Baltimore, MD)
    …based on business needs and work activities/deliverables that week. The Director, Utilization Management provides strategic leadership of the utilization ... and is responsible for the design, assessment, implementation and outcomes of utilization management strategies using a multidisciplinary approach to enhance… more
    CareFirst (08/27/24)
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  • Interim Manager - Case Management

    Trinity Health (Silver Spring, MD)
    …closely related area. + Extensive knowledge of payer mechanisms and clinical utilization management is required. + Knowledge of pertinent regulatory, ... Full time **Shift:** **Description:** The Interim Manager of Care Management & Utilization Review, under the supervision...applicable):** + State of Maryland license as a Registered Nurse + RN with BSN or RN with >… more
    Trinity Health (10/10/24)
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  • Utilization Management Specialist…

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist, will analyze clinical information, contracts, mandates,… more
    CareFirst (11/07/24)
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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 Clinic ... staff training/ education and development. In partnership with the Clinic Supervisor, the Nurse Manager provides oversight to the clinical staff (RNs/ CMAs) in three… more
    Johns Hopkins University (10/31/24)
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  • Clinical Appeals Nurse (Remote)

    CareFirst (Baltimore, MD)
    …psychiatric setting. **Preferred Qualifications:** + 2 years' experience in Medical Review, Utilization Management or Case Management at CareFirst BlueCross ... of regulatory and accreditation requirements, understanding of appeals process and utilization management , and systems software used in processing appeals.… more
    CareFirst (11/09/24)
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  • CO Nurse Practitioner

    Johns Hopkins University (Baltimore, MD)
    The Department of Surgery, Bayview Campus is seeking a **_CO Nurse Practitioner_** (Mid-Level Provider - MLP) to work collaboratively within a multidisciplinary ... limited to the following advance procedures, wound care and management , suture and staple removal; phlebotomy, IV placement, removal...4, 5 drugs under the guidelines of the Maryland Nurse Practice Act and the DEA. _Research Coordination_ +… more
    Johns Hopkins University (09/12/24)
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  • Sr. Nurse Practitioner

    Johns Hopkins University (Washington, DC)
    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 (09/25/24)
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  • Clinical Appeals Manager - RN (Hybrid)

    CareFirst (Baltimore, MD)
    …leadership experience. + Master's in Science Nursing or related field, Legal Nurse Consultant, Utilization Management , and Government Program experience ... of regulatory and accreditation requirements, understanding of appeals process and utilization management , and systems software used in processing appeals.… more
    CareFirst (11/09/24)
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  • Nurse Supervisor - Med/Surg/Tele (Nights)

    Trinity Health (Germantown, MD)
    …Full time **Shift:** 12 Hour Night Shift **Description:** **Job Title:** Nurse In Charge/ Nurse Supervisor **Unit:** Med/Surg/Tele **Employment Type:** Full ... + **Advancement:** Opportunities to advance within the organization **Description:** The Nurse in Charge (NIC)/ Nurse Supervisor is a designated clinical… more
    Trinity Health (09/29/24)
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  • Nurse (Consultant-Informatics)

    National Institutes of Health (Montgomery County, MD)
    …candidates who are looking to embark on an exciting career opportunity. As a Nurse (Consultant-Informatics), you will use your skills and insights to lead a dynamic ... competence. Developing, maintaining, and enhancing own leadership and project management skills through self-evaluation and ongoing professional development. Analyzing… more
    National Institutes of Health (11/09/24)
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  • Nurse in Charge-Weekend

    Trinity Health (Silver Spring, MD)
    **Employment Type:** Part time **Shift:** Weekend Shift **Description:** **Job Title:** Nurse In Charge position for the Operating Room **Employment Type:** ... Advancement Program + **Location:** Holy Cross Health, Silver Spring, MD **Description:** The Nurse in Charge (NIC) is a designated clinical leader for a patient… more
    Trinity Health (10/24/24)
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  • Employee Health Nurse Practitioner

    Erickson Living (Silver Spring, MD)
    Location: Riderwood Village by Erickson Senior Living The Nurse Practitioner, Employee Health and Well-Being, under general supervision from the National Medical ... health, provides high quality, efficient and cost-effective acute care, injury management , community outbreak management , new hire assessments, immunizations,… more
    Erickson Living (10/02/24)
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  • Radiation/Oncology Lpn Nurse

    Actalent (Columbia, MD)
    …Experience with electronic health records and discharge planning. + Knowledge of utilization management and prior authorization processes. + Experience in acute ... and IV therapeutic medications in accordance with LPN/LVN state nurse practice act. Essential Skills + High school graduate...Minimum of 3 years of experience as a practical nurse . + Current LPN state license and registration with… more
    Actalent (10/30/24)
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  • Nurse Supervisor - Labor and Delivery

    Trinity Health (Silver Spring, MD)
    …Type:** Full time **Shift:** 12 Hour Day Shift **Description:** **Job Title:** Nurse Supervisor - Labor and Delivery **Employment Type:** Full Time **Shift:** Days ... + Full-Time/Days + Reporting to the Director of Labor and Delivery + The Nurse in Charge (NIC) is a designated clinical leader for a patient care area… more
    Trinity Health (11/07/24)
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  • Nurse Supervisor Muti Environmnet IMCU Unit

    Trinity Health (Silver Spring, MD)
    …and accountable for: + Cost effective decision-making regarding operations including utilization and application of resources. (ie, human resources, patient care ... including orientation and training. + Participating in performance evaluation and management including verbal coaching and counseling. + Participating in the… more
    Trinity Health (10/05/24)
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  • Nurse Supervisor - NICU

    Trinity Health (Silver Spring, MD)
    …Type:** Full time **Shift:** 12 Hour Night Shift **Description:** **General Summary:** The Nurse Supervisor - NICU is a designated clinical leader for a patient care ... and accountable for: + Cost effective decision-making regarding operations including utilization and application of resources. (ie, human resources, patient care… more
    Trinity Health (08/16/24)
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  • Full-Time or Part-Time Home Care RNs, Registered…

    Trinity Health (Silver Spring, MD)
    …Aides and LPNs as needed. Provides therapeutic intervention, overall care management and achievement of top decile client outcomes and patient satisfaction. ... active involvement in quality improvement activities. + Provides ongoing care management oversight/activities to assigned patients to achieve high quality care,… more
    Trinity Health (10/18/24)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Towson, MD)
    …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
    Fresenius Medical Center (09/24/24)
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