- Humana (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing (LTSS Utilization Management ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing works within specific… more
- CareFirst (Baltimore, MD)
- …+ Proficient in Microsoft Office programs. **Licenses/Certifications Required Upon Hire** : Health Services\ RN - Registered Nurse - State Licensure and/or ... week. **ESSENTIAL FUNCTIONS:** + Trains staff on standards of practice of Utilization Management and reimbursement methodologies and treatment coding. + Manages… more
- Fresenius Medical Center (Clinton, MD)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Trinity Health (Silver Spring, MD)
- …1 Benefits, 10k Sign-on Bonus & More** **Position Overview** As a Home Health Registered Nurse , you'll provide in-home skilled nursing care to patients by ... savings that make a difference. + **Supportive Leadership** Our management team is here to help you succeed every...an approved Nursing education program, BSN preferred. + Current Registered Nurse licensure in the state of… more
- Fresenius Medical Center (Baltimore, MD)
- …care pre, during and post procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques ... adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other...the facility and reports any issues to the Facility Manager . + Ensures a clean, safe and sanitary environment… more
- CVS Health (MD)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...or Specialty Pharmacy. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Ascension Health (Baltimore, MD)
- …options for post-discharge care. **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer ... Heart Association or American Red Cross accepted. + Case Manager credentialed from the Commission for Case Manager...Preferences** + One year of **recent** experience in Case Management required. + Local and national travel options are… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** Nurse Case Manager **Employment Type:** FT **Shift:** Day **Location:** Holy ... Cross Hospital **Position Purpose:** The Case Manager is responsible for implementing comprehensive case management activities for patients of all age groups.… more
- Fresenius Medical Center (Baltimore, MD)
- …the direction of the Facility Manager , Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other...the facility and reports any issues to the Facility Manager . + Ensures a clean, safe and sanitary environment… more
- Trinity Health (Silver Spring, MD)
- …Qualifications:** + Graduate of an approved Nursing education program, BSN preferred. + Current Registered Nurse licensure in the state of practice. + Must have ... the physician, and in accordance to the organization's policies and procedures. The RN is responsible for the initial assessment and care plan development in… more