• Pre - Authorization Nurse

    Humana (Annapolis, MD)
    **Become a part of our caring community and help us put health first** The Pre - Authorization Nurse 2 reviews prior authorization requests for appropriate ... and approves services or forward requests to the appropriate stakeholder. The Pre - Authorization Nurse 2 work assignments are varied and frequently require… more
    Humana (01/07/26)
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  • Quality Review Nurse (Hybrid)

    CareFirst (Baltimore, MD)
    …needs and work activities/deliverables that week. **ESSENTIAL FUNCTIONS:** + Reviews pre - authorization case files, departmental workflows and audits to ensure ... **Resp & Qualifications** **PURPOSE:** The role of the Nurse , Quality Review Utilization Management (UM) is to...and company policies and procedures as determined by the pre - authorization management team. Develops, updates, and maintains… more
    CareFirst (12/30/25)
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  • Registered Nurse (Non-Practicing)…

    Ivyhill Technologies LLC (Bethesda, MD)
    Ivyhill is currently seeking to hire a Registered Nurse (Non-Practicing) to support its contract with the Integrated Referral Management and Appointing Center ... referral management services for beneficiaries in the Defense Health Network. Registered Nurse will have overall responsibility for timely review of Right of First… more
    Ivyhill Technologies LLC (12/08/25)
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  • Clinical Care Transition Specialist / Registered…

    Option Care Health (Rockville, MD)
    …effective treatment plan. + Responsible for collecting, reviewing and completing pre -admission information and securing related signoff. + Partners with Account ... performance reviews, discipline, etc.) BASIC EDUCATION AND EXPERIENCE REQUIREMENTS Licensed Registered Nurse (RN) or licensed Pharmacist in the state of practice and… more
    Option Care Health (12/30/25)
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