- Trinity Health (Silver Spring, MD)
- …Type:** Full time **Shift:** Day Shift **Description:** **Job Title:** RN Case Manager - Utilization Management **Employment Type:** Full Time ... **Location** : Holy Cross Hospital **Position Purpose:** As a Case Manager in Utilization Management,...resource for navigating post-acute care services. **Minimum Qualifications:** + RN licensed by the State of Maryland or Compact… more
- CVS Health (Annapolis, MD)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... This position consists of working intensely as a telephonic case manager with patients and their care...in a hospital setting. + A Registered Nurse that holds an active, unrestricted… more
- CVS Health (Annapolis, MD)
- …care - Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience in ... This position consists of working intensely as a telephonic case manager with patients and their care...a hospital setting - A Registered Nurse that holds an active, unrestricted… more
- Amergis (Columbia, MD)
- Salary: $54 / Hour The Registered Nurse - Hospice Case Manager is responsible for providing care, comfort and supportto terminally ill patients. The ... Registered Nurse - Hospice assumesthe responsibility and...in the managementof patient care. Position Details: + Position: RN Hospice Case Manager (Facility-Based)… more
- CareFirst (Baltimore, MD)
- …+ Proficient in Microsoft Office programs. **Licenses/Certifications Required Upon Hire** : Health Services\ RN - Registered Nurse - State Licensure and/or ... **Resp & Qualifications** **PURPOSE:** Manages the utilization of referral services. Enhances quality of care...of services and approved claims. + Prepares retrospective reviews, case appeals, billing coordination, and clinical support. + Manages… more
- Calvert Memorial Hospital (Prince Frederick, MD)
- …BSN or bachelor's degree in a related field, preferred. + Registration/Certification/Licensure : + Registered Nurse ( RN ) License from State of Maryland or ... JOB DESCRIPTION DETAILS + Job Summary : + Performs utilization review and discharge planning to patients through the...Compact State preferred. Licensed Practical Nurse (LPN) License acceptable with case management… more
- Highmark Health (Annapolis, MD)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case management, and… more
- Trinity Health (Silver Spring, MD)
- …assessment and care plan development in collaboration with the Population Health Case Manager . Provides functional support/supervision to Home Healthcare Aides ... Qualifications:** + Graduate of an approved Nursing education program, BSN preferred. + Current Registered Nurse licensure in the state of practice. + Must have… more
- Elevance Health (MD)
- …with IDD and patients with special needs is preferred. + Home Health, Utilization Management or Case Management experience strongly preferred. + Previous ... **Transitions of Care - RN , 100% Virtual, CareBridge** Location: This role enables...agencies and appropriate provider/network. + Refers member to catastrophic case management. **Minimum Requirements:** Requires AS in nursing and… more
- Prime Therapeutics (Annapolis, MD)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for drug services. + Will actively maintain a required case load and the activities to reach overall goals...for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5… more
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