- 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 (UM) Nurse 2 RN utilizes clinical nursing skills to support ... enhanced licensure, (eNLC) without disciplinary action + 1+ year previous experience in utilization management + 2+ years prior clinical experience preferably in… 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
- AmeriHealth Caritas (Washington, DC)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- Trinity Health (Silver Spring, MD)
- …Counties** **Day 1 Benefits, 10k Sign-on Bonus & More** **Position Overview** As a Home Health Registered Nurse , you'll provide in- home skilled nursing care ... **Employment Type:** Full time **Shift:** **Description:** **Looking for Full-Time Home Health RNs to service our patients in and...savings that make a difference. + **Supportive Leadership** Our management team is here to help you succeed every… more
- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Sharecare (Washington, DC)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …to benefits of interventions and their outcomes; Knowledge of resources planning, management , and utilization ; Knowledge of County personnel policies and ... and children. + Experience in maternal and child health nursing, including immunizations, home visiting, and case management . + Ability to address health… more
- Prime Therapeutics (Washington, DC)
- …of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing criteria. + At ... and drives every decision we make. **Job Posting Title** Infusion Referral Nurse Sr- REMOTE **Job Description** Under supervision, is responsible for performing… more
- BrightSpring Health Services (Arlington, VA)
- … utilization and hospital admission reduction. + Provides survey management support/ follow-up/and coordination of corrective actions plans relatied to care ... home health care, + Three years' experience in an administrative/supervisory/quality management role in a Medicare certified home health agency generally… more