- Trinity Health (Silver Spring, MD)
- …the activities of RN Case Managers for in inpatient care coordination and utilization review . Oversees interactions of staff with outside activities and agencies ... required. + Extensive knowledge of payer mechanisms and clinical utilization management is required **Preferred:** + At...in an acute healthcare setting. + Designation Changes and Utilization Review + Knowledge of pertinent regulatory,… 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 ... 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
- Humana (Washington, DC)
- …and ad 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
- Humana (Washington, DC)
- …**Preferred Qualifications** + Registered Nurse + Experience in Medicare Utilization Management + Project Management Professional (PMP) certification ... are addressed. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality… 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
- Johns Hopkins University (Washington, DC)
- …support in response to emergency situations. + Prepare chart documentation for review and counter signature by the physician. + Determine differential diagnosis. + ... to obtain informed consent from study participants. + Remain proficient in the utilization of commonly used clinical protocols and guidelines. + Remain abreast of… more
- Fresenius Medical Center (Alexandria, VA)
- …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
- Trinity Health (Silver Spring, MD)
- … initiatives. Completes comprehensive assessment of patient situations utilizing Case Management documentation standards, review of medical record, collaboration ... position requires a minimum of two years of experience in Social Work Case Management within an acute care facility. Additional training to learn the role will not… 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 ... Level:** Non- Management Exempt **Workshift:** **Job Family:** MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation… more
- Sunrise Senior Living (Arlington, VA)
- …per state regulations. + A minimum of two (2) years' experience in a nurse management position within a skilled nursing environment including hiring staff, ... The Director of Nursing Services is responsible for providing leadership and management to the skilled nursing operations. Responsible for planning, organizing and… more
- Cardinal Health (Washington, DC)
- …for physician leaders and physician board regarding all areas of practice management and operations. This leader has primary responsibility to manage and drive ... will be needed in the following areas: practice operations, revenue cycle management , patient growth and practice marketing, value-based care, payor relations, EHR,… more
- CVS Health (Falls Church, VA)
- …collaborative position working proactively with the Aetna account team, Aetna's Care management teams, and key National and Enterprise account partners to support ... consultative clinical insights based on analysis of clinical plan utilization and impact of member behavior on medical plan...up to 25% travel to meet with customers and review plan performance, discuss recommendations, etc. In this role,… more