- Humana (Annapolis, MD)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Annapolis, MD)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- CenterWell (Annapolis, MD)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** 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
- Ascension Health (Baltimore, MD)
- …time of hire. **Additional Preferences** + One year of **recent** experience in Utilization Management required. + Local and national travel options are ... for post-discharge care. **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer date required. +… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... of business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement, change adoption… more
- Veterans Affairs, Veterans Health Administration (Baltimore, MD)
- …the EDRP application. Former EDRP participants ineligible to apply. Responsibilities The Nurse Community Living Center (CLC) Registered Nurse (RN) is responsible ... of licensed vocational nurses/nursing assistants, as appropriate to the setting. The nurse will assist in directing the provision of nursing education, orientation,… more
- Johns Hopkins University (Baltimore, MD)
- …guidelines of the department and institution and in accordance with the Nurse Practitioner-Physician Written Agreement required and approved by the State of Maryland ... and the Nurse Practice Act of the State of Maryland. Is...long-term effects of radiation and provides accurate and timely management for such side effects. + Provides education to… more
- CVS Health (Annapolis, MD)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… 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 ... ** Nurse Reviewer I** **Virtual:** This role enables associates...required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… more
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