- 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 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)
- **Resp & Qualifications** **PURPOSE** : Supervise the daily operations of the utilization management (UM) department functions to ensure appropriate coordination ... expected to work a portion of their week from home and a portion of their week at a...business. **Knowledge, Skills and Abilities (KSAs)** + Oversight of Utilization Management clinicians while championing process improvement,… more
- Trinity Health (Silver Spring, MD)
- …MD Area** **Position Overview - Day 1 Benefits, 10k Sign-on Bonus & More** As a Home Health Registered Nurse , you'll provide in- home skilled nursing care to ... **Employment Type:** Full time **Shift:** **Description:** **Holy Cross Home Care Team is looking for a Fu**...savings that make a difference. + **Supportive Leadership** Our management team is here to help you succeed every… more
- BAYADA Home Health Care (Bel Air, 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/Harford Counties** **_._** Are you a solutions-oriented, team-focused **Registered Nurse , Licensed Practical Nurse or Therapist (Physical Therapist,… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Nurse , Quality Review Utilization Management (UM) is to evaluate clinical quality and procedures ... within the Utilization Management (UM) program to maximize efficiency,...expected to work a portion of their week from home and a portion of their week at a… 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
- CenterWell (Annapolis, MD)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
- Evolent (Annapolis, MD)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Evolent (Annapolis, MD)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
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