- One Medical (Washington, DC)
- …Ongoing collaboration with both virtual and in-office teammates via daily huddles Utilization of your specific clinical training and opportunities to give ... care services, on-site labs, and programs for preventive care, chronic care management , common illnesses and mental health concerns have been delighting people for… more
- Cognizant (Washington, DC)
- …+ Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical … more
- AmeriHealth Caritas (Washington, DC)
- **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring ... in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong...(BSN) preferred + Minimum of 3 years of diverse clinical experience as a Registered Nurse in… more
- Immigration and Customs Enforcement (Washington, DC)
- …with the IHSC Medical Quality Management Unit. SUPERVISORY CONTROLS: The Clinical Senior Nurse Specialist, Medical Asset Support Team (MAST) member works ... of complex tasks requiring developed proficiency/ higher responsibility: serving as Clinical Coordinator/ Acting Nurse Manager/ Acting Regional Nurse… more
- Evolent (Washington, DC)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- Fresenius Medical Center (Washington, DC)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Fresenius Medical Center (Capitol Heights, MD)
- Job Description About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining ... clinical operations. As the facility leader, you will be...of Disease (ICD) coding. Manages clinic financials including efficient utilization of supplies or equipment and regular profits and… more
- Battelle Memorial Institute (Arlington, VA)
- …as a case manager by a recognized certifying organization, ie, Commission for Case Management Certification or American Nurse Credentialing Center + At least two ... Research and Analytics (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support of our government customer,… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …program. Must have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management (UM) experience is preferred. ... Ivyhill is currently seeking to hire a Registered Nurse (Non-Practicing) to support its contract with the Integrated Referral Management and Appointing Center… more
- Trinity Health (Silver Spring, MD)
- …needs. As the designated Nurse Supervisor, you'll coordinate staffing, resource management , and clinical workflows to ensure optimal outcomes and regulatory ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Clinical Nurse Supervisor - Dialysis** **Location: Holy Cross Hospital** **Employment… more
- Trinity Health (Silver Spring, MD)
- …Advancement Program + **Location:** Holy Cross Health, Silver Spring, MD **Description:** The Nurse Supervisor is a designated clinical leader for a patient care ... **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** Nurse Supervisor- IMC **Employment** **Type:** Full time / Day Shift… more
- CVS Health (Washington, DC)
- …health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care, ... education, connecting members to resources, and facilitating referrals to care management programs for continued support. This position supports the development and… more
- Evolent (Washington, DC)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... accomplishments. **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- Elevance Health (Washington, DC)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures, chairs and schedules meetings, as ... ** Nurse Case Manager Sr** **Location:** Washington, DC. This... Case Manager Sr** will be responsible for care management within the scope of licensure for members with… more
- Trinity Health (Silver Spring, MD)
- …Day 1 Benefits, 10k Sign-on Bonus & More** As a Home Health Registered Nurse , you'll provide in-home skilled nursing care to patients by developing personalized care ... this role offers a rewarding opportunity to apply your clinical expertise in a more independent, patient-focused environment. **Why...savings that make a difference. + **Supportive Leadership** Our management team is here to help you succeed every… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Rotating Shift **Description:** **General Summary:** The Nurse in Charge (NIC) is a designated clinical leader for a ... and accountable for: + Cost effective decision-making regarding operations including utilization and application of resources. (ie, human resources, patient care… more
- Deloitte (Washington, DC)
- … registered nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG ... and informal education of physicians, CDI team, health information management and other clinical staff + Develop...medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical … more
- Howard University Hospital (Washington, DC)
- Clinical Nursing Administration Per Diem: As needed With over 150 years of caring for our community and each other in the Washington DC area, Howard University ... patient outcomes. Howard University Hospital seeks to hire a Clinical Nursing Administrator who will embrace our rich and...patients. The incumbent assists in the formulation of a nurse float pool and coordinates the daily use of… more
- Philips (Washington, DC)
- …etc) with clinical experience as Radiologic Technologist (RT) or Registered Nurse (RN) highly preferred. + Experience in healthcare (in the hospital) within ... **Sales Support, Clinical Specialist - FORS (West/National Travel)** In this...to effectively manage assigned accounts in terms of driving utilization , customer relationship management , problem resolution, etc.… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …an Associate's Degree and a minimum of 2 years of experience in Utilization Management , Referral Management , Authorization/Denials, or Medical Claims ... Team Ivyhill is currently seeking to hire Referral Management (Non- Nurse ) Reviewers to support its contract with the Integrated Referral Management and… more
