- 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
- Greenspring Village by Erickson Senior Living (Springfield, VA)
- …meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review, and Performance Improvement/Risk Management /Safety (PI/RM/S) Committee ... by Erickson Senior Living Join our team as the Nurse Manager, RN also known as the Clinical...and processes in accordance with the Erickson Senior Living Management Policies and Procedures and nursing standards of practice.… more
- Greenspring Village by Erickson Senior Living (Springfield, VA)
- …Operations Meetings, Utilization Review, and Performance Improvement/Risk Management /Safety (PI/RM/S) Committee. Reviewing clinical outcomes to ensure ... Join our team as the Assistant Director of Nursing is responsible for clinical leadership and outcomes within our Skilled, Assisted Living, and Memory Care… more
- Luminis Health (Annapolis, MD)
- …on-call status. This role supports succession planning for additional roles, such as clinical supervisor and nurse educator. Essential Job Duties: 1. Work ... staffing through effective planning and communication with the OR Clinical Supervisor or Charge Nurse and the...and ST orientation to the cardiac team. 7. Support Clinical Directors along with Materials Management and… more
- CVS Health (Washington, DC)
- …And we do it all with heart, each and every day. **Position Summary** The ** Utilization Management Clinical Nurse Consultant** utilizes clinical ... Arizona Time Zone. **Preferred Qualifications** : + Previous experience with utilization management . + Previous clinical experience in Emergency Department,… more
- Humana (Annapolis, MD)
- …help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Annapolis, MD)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- Summary The Patient Flow - Utilization Management Coordinator Registered Nurse (RN) considers all characteristics of the individual, in order to assist each ... RN. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases,...with two years of case management and utilization experience. Five years of clinical experience… more
- CenterWell (Washington, DC)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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
- Evolent (Washington, DC)
- … Reviewer, Nurse , you will routinely interact with leadership and management staff, other CR's ( Clinical Reviewers), providers, office staff and Field ... culture. **What You'll Be Doing:** Job Description As a Clinical Reviewer, Nurse , you will be a..., you will be a key member of the utilization management team. We can offer you… 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
- 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
- Elevance Health (Hanover, MD)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location:** This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum requirements:**… 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 ... **Pediatric 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
