- Humana (Washington, DC)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- Baylor Scott & White Health (Washington, DC)
- …of staff, resource management , and budget control. Departments involved are Utilization Management , Case Management , and Disease Management . ... Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels....experience + Hold a valid registration as a Registered Nurse As a health care system committed to improving… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …to benefits of interventions and their outcomes; Knowledge of resources planning, management , and utilization ; Knowledge of County personnel policies and ... Public Health Nurse IV - Clinical Nurse Informatics...public health nursing programs; Knowledge of budget and financial management principles and practices to include assessing costs relative… more
- Trinity Health (Silver Spring, MD)
- …and patients often require cardiac telemetry monitoring and/or mechanical ventilator support. The Nurse in Charge (NIC) is a designated clinical leader for a patient ... and accountable for: + Cost effective decision-making regarding operations including utilization and application of resources. (ie, human resources, patient care… more
- Trinity Health (Germantown, MD)
- …Full time **Shift:** 12 Hour Night Shift **Description:** **Job Title:** Nurse In Charge/ Nurse Supervisor **Unit:** Emergency Department **Employment Type:** ... + **Advancement:** Opportunities to advance within the organization **Description:** The Nurse in Charge (NIC)/ Nurse Supervisor is a designated clinical… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …nursing 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
- Fairfax County Sheriff's Office (Fairfax, VA)
- Clinic Public Health Nurse II Print (https://www.governmentjobs.com/careers/fairfaxcounty/jobs/newprint/4773528) Apply Clinic Public Health Nurse II Salary ... in developing appropriate health care plans; Documents health care service utilization , client outcomes, and information regarding referrals and follow-up of… 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 is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Hanover, MD)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... required. **Preferred Skills, Capabilities, and Experiences** **:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more
- Erickson Living (Silver Spring, MD)
- Location: Riderwood Village by Erickson Senior Living The Nurse Practitioner, Employee Health and Well-Being, under general supervision from the National Medical ... health, provides high quality, efficient and cost-effective acute care, injury management , community outbreak management , new hire assessments, immunizations,… more
- Trinity Health (Silver Spring, MD)
- …and accountable for: + Cost effective decision-making regarding operations including utilization and application of resources. (ie, human resources, patient care ... including orientation and training. + Participating in performance evaluation and management including verbal coaching and counseling. + Participating in the… more
- Koniag Government Services (Camp Springs, MD)
- …Koniag Government Services company, is seeking a full time Occupational Health Registered Nurse to support **KPS** and our government customer in Camp Springs, MD. ... provided. + Prepare and submit required reports, including quarterly and annual utilization reports + Manage and maintain medical equipment and supplies + Provide… more
- Actalent (Rockville, MD)
- …Experience with electronic health records and discharge planning. + Knowledge of utilization management and prior authorization processes. + Experience in acute ... and IV therapeutic medications in accordance with LPN/LVN state nurse practice act. Essential Skills + High school graduate...Minimum of 3 years of experience as a practical nurse . + Current LPN state license and registration with… more
- Trinity Health (Silver Spring, MD)
- …Aides and LPNs as needed. Provides therapeutic intervention, overall care management and achievement of top decile client outcomes and patient satisfaction. ... active involvement in quality improvement activities. + Provides ongoing care management oversight/activities to assigned patients to achieve high quality care,… more
- Fresenius Medical Center (Lanham, MD)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... by working with the Vice President of Quality and other organization management to ensure that organization/ASC policies and procedures are followed. + Responsible… more
- Sharecare (Washington, DC)
- …other members of the health care team to support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality ... the participants and their Primary Care Provider according to the disease management program intervention guidelines. An RN is supervised by an Operations Manager… more
- Fresenius Medical Center (Alexandria, VA)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… 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
- Ivyhill Technologies LLC (Bethesda, MD)
- …nursing 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 Referral Management (RN) Training Manager to support its contract...all the duties and requirements of the Referral Registered Nurse and the the RM Reviewers. Requirements Qualified candidate… more
- Evolent (Washington, DC)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… more