- Evolent (Annapolis, MD)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Elevance Health (Hanover, MD)
- ** Nurse Reviewer I** A proud member...reviews that are routine having limited or no previous medical review experience requiring guidance by more ... Hours:** **Monday through Friday, 9:30AM - 6PM (CST).** The ** Nurse Reviewer I** is responsible for conducting...+ Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request… more
- CareFirst (Baltimore, MD)
- …State and Federal regulations and mandates. + Organizes the appeal case for physician review by compiling clinical , contractual, medical policy and claims ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic...psychiatric setting. **Preferred Qualifications:** + 2 years experience in Medical Review , Utilization Management or Case Management… more
- Fresenius Medical Center (Annapolis, MD)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Alaka'ina Foundation Family of Companies (Silver Spring, MD)
- Clinical Research Coordinator III (Registered Nurse ) Location MD - Silver Spring Job Code 13347 # of openings 1 Apply Now ... - 2:30 PM The Alaka`ina Foundation Family of Companies is looking for a Clinical Research Coordinator III (Registered Nurse ) to support our government customer… more
- Actalent (Westminster, MD)
- Job Title: Clinical Research Coordinator Job Description Join our team as a Clinical Research Nurse for an ongoing clinical trial, where you will play a ... crucial role in facilitating clinical research activities within a dynamic healthcare setting. This...care and support to patients throughout the study. + Review patient charts and electronic medical records… more
- Alaka'ina Foundation Family of Companies (Frederick, MD)
- Training Clinical Nurse Location MD - Frederick Job Code 12628 # of openings 1 Apply Now ... Companies (FOCs) has a potential need for a Training Clinical Nurse to support our government customer...prepared materials and proposed revisions to Division leadership for review . + In collaboration with the DoM Chief of… more
- Elevance Health (Hanover, MD)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Clinical Fraud Investigator II** is responsible… more
- Humana (Annapolis, MD)
- …Manager, Fraud and Waste Investigator: Nurse Audit/ Review performs clinical audit/validation processes to ensure that medical record documentation and ... approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to… more
- Fresenius Medical Center (Baltimore, MD)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
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