Top 9 Utilization management nurse Jobs in Lexington Park, Md

Nurse Navigator Ambulatory Bariatrics
MedStar Health —Leonardtown, MD
- $89,065 - $162,801 a year
- Full-time
- Nursing
- RN License
- Computer literacy
APPEALS COORDINATOR
Calvert Health System —Prince Frederick, MD
- $35 - $50 an hour
- Part-time
- Nursing
- RN License
- Computer literacy
Quick Apply
Claims Nurse (Utilization Management / Claims Review) Must have CALIFORNIA license
Dragonfly Global —United States
- $100,000 - $105,000 a year
- Full-time
- Remote
- LVN
- RN License
- Mid-level
- Travel reimbursement
- Health savings account
Quick Apply
Remote Registered Nurse (RN) | $34/hr
Carenet Health —United States
- $34 an hour
- Weekends as needed
- Remote
- Bilingual
- Nursing
- RN License
- Continuing education credits
- Paid holidays

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APPEALS COORDINATOR
Calvert Health System —Prince Frederick, MD
Knowledge of revenue cycle operations including state and federal reimbursement policies. Maintains unit-specific and hospital competencies, mandatory learning,…
$35 - $50 an hour
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IT Coordinator - Enterprise Programs
Prince George's County, MD Government —Largo, MD
Provide technical support and troubleshooting assistance for enterprise applications, data systems, reporting tools, and related technology platforms.
$87,500 - $118,753 a year
6d

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Nurse Navigator Ambulatory Bariatrics

MedStar Health -
Leonardtown, MD

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Job Details

Full-time
$89,065 - $162,801 a year

Qualifications

Computer operation
RN License
Computer literacy
BLS Certification
Bachelor of Science in Nursing
Bachelor's degree in nursing
Computer skills
Community relationship building

Full Job Description

About this Job:

General Summary of Position
Responsible for the coordination of patient care across the continuum under the auspices of a provider's prescribed plan of care, national guidelines, and within the scope of nursing practice. The navigator educates/provides information and support to patients to guide and facilitate understanding of treatment plans prescribed by licensed independent practitioners and/or within the scope of nursing practice. Oversees, directs, and provides holistic, culturally competent, and evidence-based nursing care. Monitors patient outcomes and participates in quality improvement activities. Contributes to and collaborates with health care team members to positively impact patient outcomes and patient experiences. The Nurse Navigator is recognized as a professional role model and clinical expert and promotes a professional environment that supports nursing excellence and collaborative shared decision-making.

Primary Duties and Responsibilities

Assessment: Obtains a baseline of information used for the development of the individualized plan of care.
Plans: Works with an interdisciplinary team throughout the continuum of care to develop and manage the plan of care for the patient. Assists patient/family with scheduling ancillary testing and other services and presenting necessary history diagnostic/treatment studies and/or results etc. through the continuum of care. Assists at risk patients family and friends with risk assessment screening and education by working collaboratively with appropriate resources.
Patient Education: Provides initial and continuing education related to specific disease process associated treatment modality and agreed plan of care for patient and family. Available as a resource to assist in the provision of community education and outreach development.
Implementation: Acts as a liaison between patients families the health care team community resources and other facilities to coordinate the provision of care. Acts as a patient advocate to help identify and eliminate barriers to care. Acts as a clearinghouse for incoming referral calls in an effort to streamline the delivery and coordination of care. Ensures patients' referral process and transition into specialty services are timely and efficient anticipates patient and family needs throughout the continuum of care. Explores and connects patients with appropriate resources health care and support services within assigned entity at other external facilities and in their communities for timely diagnosis treatment and survivorship.
Supports and promotes quality and patient safety initiatives. Collaborates with physicians and associates to monitor and analyzes departmental performance data and identifies and participates in hospital and/or unit-based performance improvement activities including but not limited to core measures nursing quality indicators and other patient care outcomes (e.g. Length of stay and patient satisfaction). *Delivers direct patient care as required.
Evaluation: Monitors patient progress goal attainment and patient experience feedback to evaluate the effectiveness of care. Ensures plan of care changes are communicated to patient family and team.
Possesses working knowledge of physician/health care team members' plan of care appropriate professional guidelines and standards of care. Contributes to development of internal clinical guidelines/pathways.
Monitors patient outcomes and utilizes quality improvement activities and strategies that support quality patient care and optimizes outcomes in an interdisciplinary care environment and consistent with patient and family wishes.
Demonstrates competencies including knowledge and behaviors to meet specific patient care requirements nursing practice standards and other regulatory or required knowledge and /or skills.* Maintains current knowledge of clinical improvement strategies and outcomes management through self-study literature reviews site visits educational conferences and other forums.
May be responsible to maintain a working knowledge of available clinical trials that might be appropriate to the patient population. Collaborates with research coordinators and/or principal investigators to ensure adherence to research protocols.
Supports a professional atmosphere and an environment of coaching and development that supports shared decision making interdisciplinary collaboration and a high level of patient and employee satisfaction as evidenced by outcomes data.
Oncology: Manages and tracks budgets of Cancer Committee approved support groups. Reviews available health education materials and makes recommendations for utilization. Coordinates and facilitates to patients in our service area the Cancer Committee approved support programs. Provides the necessary support to the Tumor Registrar in a timely manner. Actively participates in routine Tumor Boards/Cancer Conferences. Develops and maintains partnerships with physicians to promote utilization of MGH Cancer Center the Navigator and other MGH Cancer-related services. Participates in planning and administration of hospital organized education/prevention and cancer screenings. Provides screening results/navigation follow up and reports this information to Cancer Committee.
Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Assures compliance with Federal and State regulations.
Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.

Minimal Qualifications
Education

Bachelor's degree BSN required and
Master's degree in Nursing preferred

Experience

3-4 years of progressively more responsible clinical nursing experience in specialty area required and
Case Management discharge planning or Oncology experience may be preferred based on location preferred

Licenses and Certifications

RN - Registered Nurse - State Licensure and/or Compact State Licensure in the State of Maryland or District of Columbia Upon Hire required and
AOCN - Advanced Oncology Certified Nurse based on location Upon Hire preferred and
CPR - Cardiac Pulmonary Resuscitation (includes BLS and NRP) for healthcare providers from either the American Heart Association (AHA) or American Red Cross within 90 Days required and
Additional unit/specialty certifications may vary by department or business unit.

Knowledge Skills and Abilities

Strong assessment skills of patient needs and concerns.
Ability to perform duties autonomously under direction of multiple disciplines.
Basic computer skills.
Effective interpersonal skills including excellent verbal and written communication skills.

This position has a hiring range of : USD $89,065.00 - USD $162,801.00 /Yr.

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utilization management nurse jobs in lexington park, md

Nurse Navigator Ambulatory Bariatrics

APPEALS COORDINATOR

Claims Nurse (Utilization Management / Claims Review) Must have CALIFORNIA license

Remote Registered Nurse (RN) | $34/hr

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