- Humana (Washington, DC)
- **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
- Elevance Health (Washington, DC)
- …office 4 days each week. The office is located at 609 H. Street NE.** The ** Utilization Management ** ** Manager ll** is responsible for managing a team of ... acuity. + Provides direct oversight and is responsible for Utilization Management execution/decision making for managed member...as aligned to license which includes 3 years prior management experience + Current active unrestricted RN … 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
- CVS Health (Washington, DC)
- …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
- Select Medical (Alexandria, VA)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... current licensure in a clinical discipline either as a Nurse ( RN /LPN/LVN) or a Respiratory Therapist (RT)...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Erickson Living (Springfield, VA)
- …(skilled nursing, long term care, assisted living or hospital) is required. + Current Registered Nurse license for the state in which they operate. + Current ... leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review, and Performance Improvement/Risk Management /Safety (PI/RM/S) Committee… 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
- 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
- Elevance Health (Arlington, VA)
- …an accommodation is granted as required by law._ The **LTSS Service Coordinator RN Clinician** is responsible for overall management of member's case within ... the scope of licensure; provides supervision and direction to non- RN clinicians participating in the member's case in accordance with applicable state law and… more