LifeBridge HealthNewUtilization Review Nurse RN - NE LifeBridge HealthUtilization Review Nurse RN - NERandallstown, MD$40.12–$62.19 / hourAssists nurse Care Managers in communicating with the patient denied hospital days as well as the issuance of Medicare forms including HINN, Detailed Notice of Discharge to patients/family/significant other when they are in disagreement with the discharge plan arranged by attending and Care Management personnel. Support: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support — improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.
TravelNurseSourceNewTravel Nurse RN - Utilization Review - $1,461 per week in Baltimore, MD TravelNurseSourceTravel Nurse RN - Utilization Review - $1,461 per week in Baltimore, MDBaltimore, MD$1,461–$1,461Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
Homewood Living MinistriesNewRN Unit Manager Homewood Living MinistriesRN Unit ManagerFrederick, MD$90,000–$103,000 / yearThe Unit Manager works closely with nursing leadership, interdisciplinary teams, and frontline staff to support resident care, address clinical concerns, and foster a collaborative team culture. Reviews assignments for daily resident care tasks for Nursing Assistants, Hospitality Aides and Team Leaders, and monitors/evaluates the delivery of care for sound judgment, safety and customer service.
AccentCare, Inc.Nurse Practitioner - Hiring Now AccentCare, Inc.Nurse Practitioner - Hiring NowColumbia, MD$50–$62We’re proud to be named one of America’s Greatest Workplaces 2025 by Newsweek — a reflection of our shared commitment to excellence, integrity and compassion as we shape the future of aging in place. Initiate communication with attending physicians, other Palliative Care staff members and other agencies as needed to coordinate optimal care and use of resources for patient/family.
AccentCare, Inc.Nurse Practitioner - Hospice AccentCare, Inc.Nurse Practitioner - HospiceColumbia, MD$50–$62We’re proud to be named one of America’s Greatest Workplaces 2025 by Newsweek — a reflection of our shared commitment to excellence, integrity and compassion as we shape the future of aging in place. Initiate communication with attending physicians, other Palliative Care staff members and other agencies as needed to coordinate optimal care and use of resources for patient/family.
AccentCare, Inc.Nurse Practitioner, Palliative Care PRN AccentCare, Inc.Nurse Practitioner, Palliative Care PRNColumbia, MD$50–$62We’re proud to be named one of America’s Greatest Workplaces 2025 by Newsweek — a reflection of our shared commitment to excellence, integrity and compassion as we shape the future of aging in place. Initiate communication with attending physicians, other Palliative Care staff members and other agencies as needed to coordinate optimal care and use of resources for patient/family.
MedStar HealthEmergency Department Nurse Manager - Relocation Offered! MedStar HealthEmergency Department Nurse Manager - Relocation Offered!Olney, MD$120,702–$238,222Maintains knowledge of current trends and developments in the fields of nursing and health care through a variety of professional activities including but not limited to reading the appropriate literature attending related seminars and conferences and maintaining membership in professional nursing associations. Engages in ongoing productivity monitoring adherence to prescribed annual budget and assurance of adequate availability of personnel and other necessary resources to support the delivery of safe patient care and realization of departmental goals.
MedStar HealthNewDirector of Nursing (RN) Operating Room, Abdominal Transplant, Robotics and General Surgery - Relocation Offered! MedStar HealthDirector of Nursing (RN) Operating Room, Abdominal Transplant, Robotics and General Surgery - Relocation Offered!Washington, DC$120,702–$238,222Maintains knowledge of current trends and developments in the fields of nursing and health care through a variety of professional activities including but not limited to reading the appropriate literature attending related seminars and conferences and maintaining membership in professional nursing associations. Engages in ongoing productivity monitoring adherence to prescribed annual budget and assurance of adequate availability of personnel and other necessary resources to support the delivery of safe patient care and realization of departmental goals.
Brightview Senior Living, LLCNewLPN/Wellness Nurse (Part Time) Brightview Senior Living, LLCLPN/Wellness Nurse (Part Time)Nottingham, MD$32.25–$38.754. Comprehensive Benefits: Enjoy competitive salaries, health, vision and dental insurance options, retirement plans, tuition reimbursement, employee assistance programs and many more benefits that prioritize your well-being. Compensation Disclosure: The salary range mentioned above reflects the potential pay for this role and does not include bonuses or additional incentives (if applicable), nor does it include the value of our benefit program.
Larkin Chase CenterNewWound Care and Skin Health Team Lead, RN Larkin Chase CenterWound Care and Skin Health Team Lead, RNBowie, MD$50–$52Must have national accredited wound certification (CWS, CWCN, WCC, CWON, WOC, AWCC)or be committed to complete Advanced Wound Training and national accredited Wound Certification within 1 year of hire (For those hired with wound certification, completion of a fast-track hybrid program for regulatory wound care requirements will be provided) . As a leading provider in the long-term care industry, we believe in fostering a collaborative, inclusive and supportive work environment where every team member is valued and empowered to make a difference.
Inspir Embassy Row, LLCNewWellness Nurse - Full-Time 3pm - 11pm Inspir Embassy Row, LLCWellness Nurse - Full-Time 3pm - 11pmWashington, DC$38–$40Known nationally for innovation in the senior living space, Maplewood is a growing company dedicated to excellence in care, offering personalized and thoughtful services in independent living, assisted living and memory care. Position Summary:The Resident Services Nurse (Licensed Practical Nurse) is responsible for assisting the Resident Services Director with the overall implementation, delivery, and coordination of Resident Care Services at the Community.
MedStar HealthNewNursing Director (RN) Behavioral Health - Relocation Offered! MedStar HealthNursing Director (RN) Behavioral Health - Relocation Offered!Washington, DC$120,702–$238,222Maintains knowledge of current trends and developments in the fields of nursing and health care through a variety of professional activities including but not limited to reading the appropriate literature attending related seminars and conferences and maintaining membership in professional nursing associations. Engages in ongoing productivity monitoring adherence to prescribed annual budget and assurance of adequate availability of personnel and other necessary resources to support the delivery of safe patient care and realization of departmental goals.
Fusion Medical StaffingNewTravel Cath Lab RN Fusion Medical StaffingTravel Cath Lab RNBaltimore, MD$2,648–$3,044Assist in arterial and/or venous sheath removal using closure devices, manual pressure, or mechanical compression, and transport patients to the appropriate recovery area . Technical/Motor Skills - Must have the ability to grasp, perform fine manipulation, push/pull, and move about when assisting with procedures and/or using department equipment .
Brightview Senior Living, LLCNewWellness Nurse Brightview Senior Living, LLCWellness NurseAnnandale, VA$32.75–$39.254. Comprehensive Benefits: Enjoy competitive salaries, health, vision and dental insurance options, retirement plans, tuition reimbursement, employee assistance programs and many more benefits that prioritize your well-being. The salary range mentioned above reflects the potential pay for this role and does not include bonuses or additional incentives (if applicable), nor does it include the value of our benefit program.
Fairland Nsg and Rehab RHSClinical Reimbursement Coordinator, RN Fairland Nsg and Rehab RHSClinical Reimbursement Coordinator, RNSilver Spring, MD$47–$50As a leading provider in the long-term care industry, we believe in fostering a collaborative, inclusive and supportive work environment where every team member is valued and empowered to make a difference. Overview: At Genesis Healthcare, we are dedicated to improving the lives we touch through the delivery of high-quality care and exceptional service.
MedStar HealthNurse Clinician II GPG - Relocation Offered! MedStar HealthNurse Clinician II GPG - Relocation Offered!Colmar Manor, MD$35.68–$64.71Knowledge of medical equipment and instruments to administer patient care; Skill in applying and modifying the principles methods and techniques of professional nursing to provide ongoing patient care; Skill in establishing and maintaining effective working relationships with patients medical staff and the public. RN - Registered Nurse - State Licensure and/or Compact State Licensure Registered Nurse licensed in the District of Columbia Maryland or Virginia or any combination as required based on work location(s) Upon Hire required and.
MedStar HealthNewNursing Administrator (RN) Blood Marrow Harvesting Program - Relocation Offered! MedStar HealthNursing Administrator (RN) Blood Marrow Harvesting Program - Relocation Offered!Washington, DC$89,065–$162,801Oversees all aspects of Hematopoietic Stem Cell Transplantation (HSCT) Bone Marrow and Peripheral Blood Stem Cell (PBSC) Acquisition / Collection and Bone Marrow Transplant services at Georgetown University Hospital (GUH) which encompasses but is not limited to: The Blood and Marrow Collection Program affiliated with the National Marrow Donor Program (NMDP) for the procurement of blood and marrow cells from unrelated volunteer donors in response to requests from transplant centers within the NMDP network both domestic and international. Supports and assists in development of Operations Plan for the Adult program with the National Cancer Institute (NCI liaison Officer members of Lombardi Comprehensive Cancer Center (LCCC) and Georgetown University Hospital Administration.
Reston Hospital CenterRN Clinical Coordinator Medical Unit Reston Hospital CenterRN Clinical Coordinator Medical UnitReston, VAIn collaboration with other members of the management team, the CNC directs, monitors, and evaluates nursing care in accordance with established policies/procedures, serves as a resource person for staff, and models a commitment to the organization’s vision/mission/values to support an unparalleled patient experience and clinical outcomes that contribute to overall departmental performance. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
StoneSprings Hospital CenterNurse Clinical Coordinator Emergency Dept StoneSprings Hospital CenterNurse Clinical Coordinator Emergency DeptReston, VAIn collaboration with other members of the management team, the CNC directs, monitors, and evaluates nursing care in accordance with established policies/procedures, serves as a resource person for staff, and models a commitment to the organization’s vision/mission/values to support an unparalleled patient experience and clinical outcomes that contribute to overall departmental performance. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
StoneSprings Hospital CenterRegistered Nurse Emergency Department StoneSprings Hospital CenterRegistered Nurse Emergency DepartmentFairfax, VAOur medical services includes a full-service 24/7 Emergency Department, orthopedics, advanced heart and vascular care, extensive diagnostic imaging and interventional radiology capabilities, minimally invasive robotic surgery and maternal/child health. At HCA Healthcare, we are dedicated to ensuring nurses have necessary tools and resources to provide world-class patient care, advocating for the profession and helping to shape the future of nursing.".
Kaiser PermanentePatient Care Coordinator RN, Part Time, Holy Cross Hospital Kaiser PermanentePatient Care Coordinator RN, Part Time, Holy Cross HospitalSilver Spring, MDThe PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care progression for clinical and cost-effective outcomes. The PCC facilitates and coordinates with community providers and ambulatory case managers to assist with the appropriate level and transition of care for a safe discharge and preventing a re-admission.
Kaiser PermanentePatient Care Coordinator RN, Holy Cross Hospital Kaiser PermanentePatient Care Coordinator RN, Holy Cross HospitalSilver Spring, MDThe PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care progression for clinical and cost-effective outcomes. The PCC facilitates and coordinates with community providers and ambulatory case managers to assist with the appropriate level and transition of care for a safe discharge and preventing a re-admission.
Kaiser PermanentePatient Care Coordinator RN, Children's Hospital Kaiser PermanentePatient Care Coordinator RN, Children's HospitalWashington, DCThe PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care progression for clinical and cost-effective outcomes. The PCC facilitates and coordinates with community providers and ambulatory case managers to assist with the appropriate level and transition of care for a safe discharge and preventing a re-admission.
Kaiser PermanentePatient Care Coordinator RN, Short Hours, Capitol Hill MOB Kaiser PermanentePatient Care Coordinator RN, Short Hours, Capitol Hill MOBWashington, DCThe PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care progression for clinical and cost-effective outcomes. The PCC facilitates and coordinates with community providers and ambulatory case managers to assist with the appropriate level and transition of care for a safe discharge and preventing a re-admission.
MedStar HealthNewCTO Lead Care Manager RN - Relocation Offered! MedStar HealthCTO Lead Care Manager RN - Relocation Offered!Baltimore, MD$89,065–$162,801Attributed beneficiaries receive a follow up interaction from the practice within 2 days for hospital discharge and within one week for Emergency Department (ED) discharges; Coordinates referral management for attributed beneficiaries seeking care from high-volume and/or high-cost specialists as well as EDs and hospitals; Facilitates connection to services for patients who may benefit from behavioral health services including: patients with serious mental illness patients with substance use disorders' patients with depression anxiety or other mental health conditions patients with behavioral and social risk factors and BH issues patients with multiple co-morbidities and BH issues; Assists with identifying patients to participate in the Patient-Family/ Caregiver Advisory Council (PFAC) and help to organize and facilitate the PFAC annual meetings; Engages attributed beneficiaries and caregivers in a collaborative process for advance care planning (MOLST Advanced Directives Proxy). In collaboration with the interdisciplinary care team acts as primary care team agent for the coordination of care for a panel of attributed Medicare beneficiaries by ensuring the following: Ensures attributed beneficiaries have timely access to care (same day or next day access to the patient's own practitioner and/or care team for urgent care or transition management); Facilitates use of alternatives for care outside of the traditional office visit to increase access to the care team and the practitioner such as e-visits phone visits group visits home visits and visits in alternate locations (senior centers assisted living) captured in the medical record; Assists patients with scheduling appointments with providers including annual wellness visits.
Kaiser PermanenteNewPatient Care Coordinator RN, Virginia Hospital Center Kaiser PermanentePatient Care Coordinator RN, Virginia Hospital CenterArlington, VAThe PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care progression for clinical and cost-effective outcomes. The PCC facilitates and coordinates with community providers and ambulatory case managers to assist with the appropriate level and transition of care for a safe discharge and preventing a re-admission.
Sunrise Senior LivingLPN Med Care Manager Sunrise Senior LivingLPN Med Care ManagerArlington, VAAdminister, assist with, and observe medications and treatments for each resident using the medication administration record and the Six Rights of Medication Pass ("Right" resident, medication, dosage, time, route, right to refuse). Understand and practice the proper method of attending to and disposing of, and the possibility of exposure to, blood borne pathogens, bodily fluids, infectious waste, sharp sticks, and hazardous materials.
Sunrise Senior LivingResidential Healthcare Group: Home Health Rn - Evening Shift Sunrise Senior LivingResidential Healthcare Group: Home Health Rn - Evening ShiftMontgomery Village, MDPossess written and verbal skills for effective communication and the ability to teach and guide team members to provide quality clinical care Graduate of approved college/school of nursing Maintains a current state/provincial license as a professional Registered Nurse (RN) Minimum of one (1) year experience in home health, assisted living, hospital, or long-term care environment Demonstrates knowledge of nursing practices, techniques and methods applied to health and wellness resident care, and federal, state/provincial, and local regulations Demonstrates proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) and Sunrise applications with the ability to learn new applications Ability to work weekends, evenings, and flexible hours to be available to our customers at peak service delivery days and times As part of our team, you will help brighten the future for everyone at Sunrise and beyond. Quality Assurance and Regulatory Compliance Demonstrate and is knowledgeable in the following key quality improvement areas: Resident Centered Care Model Quality Care Indicators and Outcomes Actively participates in Sunrise Quality Assurance Meetings and Clinical Meetings All Federal, State/Provincial, and Local resident care and services regulations Resident Rights Resident Assessment/Evaluation process in accordance with state/provincial regulatory requirements.
StoneSprings Hospital CenterNewRegistered Nurse NICU StoneSprings Hospital CenterRegistered Nurse NICUDulles, VAOur medical services includes a full-service 24/7 Emergency Department, orthopedics, advanced heart and vascular care, extensive diagnostic imaging and interventional radiology capabilities, minimally invasive robotic surgery and maternal/child health. As a Registered Nurse NICU, your voice to influence patient care is valued and empowered at every turn –whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives.
StoneSprings Hospital CenterNewRegistered Nurse Labor and Delivery StoneSprings Hospital CenterRegistered Nurse Labor and DeliveryDulles, VAOur medical services includes a full-service 24/7 Emergency Department, orthopedics, advanced heart and vascular care, extensive diagnostic imaging and interventional radiology capabilities, minimally invasive robotic surgery and maternal/child health. As a Registered Nurse Labor and Delivery, your voice to influence patient care is valued and empowered at every turn –whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives.
Reston Hospital CenterNewRegistered Nurse Cardiovascular ICU Reston Hospital CenterRegistered Nurse Cardiovascular ICUReston, VAAdditional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. As a majority owner of Galen College of Nursing, which joins Research College of Nursing and Mercy School of Nursing as educational facilities within the HCA Healthcare family, we make it easier and more affordable to gain certifications and job skills.
Reston Hospital CenterNewRegistered Nurse Critical Care Unit Reston Hospital CenterRegistered Nurse Critical Care UnitReston, VAAs a Registered Nurse Critical Care Unit, your voice to influence patient care is valued and empowered at every turn –whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursing’s future.".
Reston Hospital CenterNewRegistered Nurse CVOR Reston Hospital CenterRegistered Nurse CVORReston, VAAs a Registered Nurse CVOR, your voice to influence patient care is valued and empowered at every turn –whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursing’s future.".
Reston Hospital CenterNewClinical Nurse Coordinator Operating Room Reston Hospital CenterClinical Nurse Coordinator Operating RoomReston, VAIn collaboration with other members of the management team, the CNC directs, monitors, and evaluates nursing care in accordance with established policies/procedures, serves as a resource person for staff, and models a commitment to the organization’s vision/mission/values to support an unparalleled patient experience and clinical outcomes that contribute to overall departmental performance. As a Clinical Nurse Coordinator Operating Room, your voice to influence patient care is valued and empowered at every turn –whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives.
Reston Hospital CenterNewRegistered Nurse Rehab Reston Hospital CenterRegistered Nurse RehabReston, VAAs a Registered Nurse Rehab, your voice to influence patient care is valued and empowered at every turn –whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursing’s future.".
Oak Crest Village by Erickson Senior LivingRN Supervisor (Full-Time) Oak Crest Village by Erickson Senior LivingRN Supervisor (Full-Time)Parkville, MD$42.50–$47 / hourLocation: Oak Crest Village by Erickson Senior LivingJoin our team as a Registered Nurse (RN) Nursing Supervisor who is responsible for the delivery of resident care by licensed and non-licensed staff in our Continuing Care Neighborhoods, which include skilled nursing, long-term care, assisted living, and memory care. Perform walking rounds through all Continuing Care neighborhoods (skilled nursing, long term care, assisted living, and memory care) to ensure nursing staff are providing the highest level of resident care possible.
LifeBridge HealthNewRegistered Nurse - Acute LifeBridge HealthRegistered Nurse - AcuteBaltimore, MD$35–$54.82 / hourAssesses and documents patient/family educational needs: to aid in informed decision making about healthcare treatment and to provide a successful transfer within the healthcare environment; coordinates with peers to establish educational resources as needed. Education: Required: * Associate's Degree in Nursing Preferred: * Bachelor of Science in Nursing Licenses And Certification: Required: * Basic Life Support * Registered Nurse License - Current Maryland license or eligibility to obtain Maryland license.
Sinai Hospital of BaltimoreNewUtilization Review Nurse RN Sinai Hospital of BaltimoreUtilization Review Nurse RNRandallstown, MDAssists nurse Care Managers in communicating with the patient denied hospital days as well as the issuance of Medicare forms including HINN, Detailed Notice of Discharge to patients/family/significant other when they are in disagreement with the discharge plan arranged by attending and Care Management personnel. Support: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support - improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.
Lumen Solutions Group IncUtilization Review Nurse Lumen Solutions Group IncUtilization Review NurseBaltimore, MDFull timeRole: Utilization Review Nurse Location: Baltimore MD(Remote) Type: Contract Job Description: We are seeking an experienced Utilization Review Nurse (LPN or RN) to support high-volume clinical reviews for commercial and FEP health plans. The ideal candidate will have strong utilization management and care management experience, expertise with MCG guidelines, and the ability to manage a fast-paced review environment while ensuring quality and compliance.
Lumen Solutions Group, Inc.Clinical Medical Review Nurse Lumen Solutions Group, Inc.Clinical Medical Review NurseBaltimore, MDWe provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support. We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, Enterprise Transformation.
TalteamHealth Services - Nurse, Clinical Medical Review TalteamHealth Services - Nurse, Clinical Medical ReviewBaltimore, MDESSENTIAL FUNCTIONS: 35% Receives, researches, reviews and analyzes professional and institutional claims using critical thinking, nursing clinical judgment and corporate/medical policies for claims processing and/or adjudication, Performs high-level research on topics identified as actual or potential medical policies. The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and/or adjudication.
Johns Hopkins HospitalNewUtilization Review Nurse - Managed Care Johns Hopkins HospitalUtilization Review Nurse - Managed CareHanover, MDRemoteAs a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the opportunity to use your clinical, managed care, utilization review, and verbal/written communication skills to make a difference in our members' lives. Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States.
Ampcus IncorporatedClinical Medical Review Nurse Ampcus IncorporatedClinical Medical Review NurseOwings Mills, MD$40–$45 / hourThe Contingent RN supports CareFirst by analyzing high cost claimant and population health data to support utilization review, ad hoc requests, and client reports. Role Characteristics:Individual contributor who researches high cost claimants, populates slide decks, and responds to ad hoc requests.
Lumen Solutions Group IncClinical Medical Review Nurse Lumen Solutions Group IncClinical Medical Review NurseBaltimore, MDFull timeRole: Clinical Medical Review Nurse Location: Canton, MD – Hybrid (2–3 days/week) Job Type: Contract Job Summary: We are seeking an experienced Clinical Medical Review Nurse to perform medical record reviews, data abstraction, and claims evaluation. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support.
Baptist Health South Florida IncUtilization Review RN, Care Coordination, Bethesda West, FT, 8A-4:30P-159236 Baptist Health South Florida IncUtilization Review RN, Care Coordination, Bethesda West, FT, 8A-4:30P-159236Bethesda, MDOur approach is rooted in a "grow our own" philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including: Career growth and development opportunities, with clear pathways and ongoing support Comprehensive health and wellness resources that go beyond traditional benefits A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs Tuition reimbursement to support continued learning and advancement And so much more Together, these benefits and others reflect our commitment to caring for our people, so they can build fulfilling careers with us while making a meaningful impact every day. Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties.
MindlanceHealth Services - Nurse, Clinical Medical Review MindlanceHealth Services - Nurse, Clinical Medical ReviewBaltimore, MDESSENTIAL FUNCTIONS: 35% Receives, researches, reviews and analyzes professional and institutional claims using critical thinking, nursing clinical judgment and corporate/medical policies for claims processing and/or adjudication, Performs high-level research on topics identified as actual or potential medical policies. Job Description:PURPOSE: The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and/or adjudication.
MedStar HealthNewRN Utilization Review (PRN) MedStar HealthRN Utilization Review (PRN)Washington, DC$89,065–$162,801 / yearServes as a resource to the health care team by educating the health care team through in-services staff meetings and formal educational settings in areas of utilization management. Performs patients' medical record reviews document pertinent information and communicate with third party payors in a timely fashion to ensure proper hospital reimbursement and eliminate unnecessary denials.
State of MarylandNURSING PROGRAM CONSULTANT/ ADMINISTRATOR I (PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR) SPECIALIST) State of MarylandNURSING PROGRAM CONSULTANT/ ADMINISTRATOR I (PREADMISSION SCREENING AND RESIDENT REVIEW (PASRR) SPECIALIST)Baltimore City, MDCandidates for positions in this classification must possess a current license as a Registered Nurse from the Maryland State Board of Nursing (4140 Patterson Avenue, Baltimore, MD 21215) or possess a current multi-state license in party states that candidates have declared as primary states of residence. Candidates may substitute the possession of a Bachelors degree in Nursing or health-related field from an accredited college or university and two years of experience as a Registered Nurse in an administrative, supervisory, consultative, or teaching capacity for the required education.
TriWest Healthcare AllianceClinical Quality Review Team Lead TriWest Healthcare AllianceClinical Quality Review Team LeadBaltimore, MDRemoteFull timeThe team lead supports clinical and non-clinical staff supporting CQM programs by providing training and onboarding of new staff; determining work assignments; performing audits for clinical records and/or work accuracy; and ensuring effective, consistent and accurate workflow. Technical Skills: Comprehensive knowledge of research methodology; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint.