Skills and Requirements Include: Ability to travel 50% by own automobile to assigned local practices. Active RN License in Maryland AND D. C. 3+ years clinical acute care Nursing experience. Utilize databases, spreadsheets, Microsoft office, and other technologies in effective manner.
A health insurance company needs applicants for an opening for a Telecommute Compliance and Auditing Nurse. Individual must be able to fulfill the following responsibilities: Review utilization management activities. Ensure adherence to policies, procedures, and regulations.
Conduct UM review. Required Skills: Current unencumbered RN license in Maryland and any other compact states. 2+ years of acute clinical experience. 4+ years of utilization management experience. Familiarity with Milliman and InterQual guidelines. Proficiency in Microsoft Word.
A staffing company is filling a position for a Telecommute Quality Nurse Analyst in Jennings. Candidates will be responsible for the following: Performing and maintaining accurate computer case records. Drawing on a wide range of clinical expertise to edit/provide credible case narratives.
3+ years experience in a leadership/management role. Knowledge of related regulations including NCQA, HIPAA, CMS. Bachelors degree or above in a related field such as Nursing, Health Care Management, or Teaching. Proficiency in Excel, Word and Adobe Acrobat.