• RN Manager - Utilization

    Ascension Health (Baltimore, MD)
    …education, experience, location, qualifications and comparison with associates in similar roles_ ** Registered Nurse , Certified Case Manager (CCM, ACM, URAC) ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
    Ascension Health (12/17/24)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Fort Washington, MD)
    **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
    Fresenius Medical Center (12/31/24)
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  • RN Hospice Case Manager

    Amergis (Columbia, MD)
    The Registered Nurse - Hospice Case Manager is responsible for providing care, comfort and supportto terminally ill patients. The Registered Nurse - ... the delivery of hospice patient carein various settings. The Registered Nurse demonstrates the abilityto make clinical...in the managementof patient care. Position Details: + Position: RN Hospice Case Manager (Facility-Based) + Location:… more
    Amergis (12/30/24)
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  • RN Manager -Post Acute Services

    Ascension Health (Baltimore, MD)
    …and salary range at the time of the offer._ **Responsibilities** Manage assigned Registered Nurse ( RN ) case managers, related activities and workflow ... including but not limited to: Access Authorization and pre-certification, utilization review and denial management, CareCoordination, Collaborative treatment… more
    Ascension Health (11/06/24)
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  • Referral Management ( RN ) Traning…

    Ivyhill Technologies LLC (Bethesda, MD)
    Nurse and the the RM Reviewers. Requirements Qualified candidate must be a Licensed Registered Nurse ( RN ), with an unencumbered active RN license ... Ivyhill is currently seeking to hire Referral Management ( RN ) Training Manager to support its...all incoming RM staff to be able to accurately review referrals utilizing the Specialty Referral Guideline (SRG) compliance… more
    Ivyhill Technologies LLC (12/10/24)
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  • Clinical Appeals Manager - RN

    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
    CareFirst (11/09/24)
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  • Clinical Appeals Supervisor - RN (Hybrid)

    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
    CareFirst (11/09/24)
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  • Care Manager RN - Weekends (Remote)

    Highmark Health (Washington, DC)
    …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
    Highmark Health (01/07/25)
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  • Manager Healthcare Services - Virginia

    Molina Healthcare (Alexandria, VA)
    **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse or LCSW who lives in VIRGINIA and must be licensed for the state of VIRGINIA. ... identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational… more
    Molina Healthcare (01/23/25)
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  • CO Research Nurse Manager

    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
    Johns Hopkins University (12/19/24)
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  • Rehabilitation/ Clinical Supervisor

    BAYADA Home Health Care (Gaithersburg, MD)
    **BAYADA Home Health Care** is seeking a full-time ** Registered Nurse ( RN ),** **Physical Therapist (PT), Occupational Therapist (OT) or Speech Language ... and dynamic environment, we offer exciting career paths. **The RN , PT, OT, or SLP Rehab Manager ...including OASIS and care plan coding + Monitor episodic utilization + Act as internal case manager more
    BAYADA Home Health Care (01/19/25)
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  • Senior Clinical Research Associate - Organ…

    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
    United Therapeutics (11/28/24)
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  • Nurse Reviewer I-2

    Elevance Health (Hanover, MD)
    …Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. + Partners ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more
    Elevance Health (01/24/25)
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  • Dialysis Facility Administrator

    Fresenius Medical Center (Alexandria, VA)
    …dialysis clinic. You will collaborate with the Medical Director and the Charge Nurse regarding the provision of quality patient care in the dialysis clinic. ... Quality, and Technical Services departments. + Collaborates with the Home Therapies Manager to oversee the facility's Home Therapies Program. + Maintains integrity… more
    Fresenius Medical Center (12/31/24)
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