- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Utilization Management (UM) Nurse 2 RN utilizes clinical nursing skills to support ... enhanced licensure, (eNLC) without disciplinary action + 1+ year previous experience in utilization management + 2+ years prior clinical experience preferably in… 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
- CareFirst (Baltimore, MD)
- …week. **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages ... expected to work a portion of their week from home and a portion of their week at a...medical practices and insurance benefit structures. + Proficient in utilization management processes, standards, and managed care.… more
- BAYADA Home Health Care (Catonsville, MD)
- **BAYADA Senior Living Solutions** , a specialty offering of BAYADA Home Health Care, was created to address the unique needs of senior living communities, and their ... Baltimore Counties **_._** Are you a solutions-oriented, team-focused **Registered Nurse , Licensed Practical Nurse or Therapist (Physical...create alignment to common goals across multiple levels of management ? Would you like to be viewed as a… more
- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Sharecare (Annapolis, MD)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… 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
- Prime Therapeutics (Annapolis, MD)
- …of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing criteria. + At ... drives every decision we make. **Job Posting Title** Infusion Referral Nurse Sr- REMOTE/Oncology exp required **Job Description** Under supervision, is responsible… more
- CareFirst (Baltimore, MD)
- …Active State Licensure and/or Compact State Licensure. **Experience:** 5 years experience in Utilization Management or Case Management at CareFirst BlueCross ... **Resp & Qualifications** **PURPOSE:** The Care Management Supervisor supervises, directs and coordinates the activities...care costs. **We are looking for an experienced Registered Nurse and people leader with UM/CM experience** **living within… more