Top 240 Nursing supervisor Jobs in Pasadena Md

RN Manager Grievances & Appeals
MedStar Health —Columbia, MD
- $102,606 - $196,996 a year
- Full-time
- Hybrid work
- Microsoft Word
- Background check
- Nursing
Quick Apply
7d
Nurse Care Management, Manager
Clinical Management Consultants —Catonsville, MD
- $105,510 - $139,520 a year
- Full-time
- Mentoring
- Senior level
- Health insurance
- Dental insurance
10d
Care Manager (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $72,360 - $143,715 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- 401(k)
Quick Apply
2d
Case Manager Registered Nurse- Field
CVS Health —Annapolis, MD
- $66,575 - $142,576 a year
- Full-time
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
OB Care Manager
Maryland Care Management Inc —Linthicum, MD
- Full-time
- Remote
- Nursing
- RN License
- Basic math
- Disability insurance
- Health insurance
9d
RN Care Manager
MARYLAND PRIMARY CARE PHYSICIANS LLC —Glen Burnie, MD
- $93,000 - $98,000 a year
- Full-time
- Background check
- Nursing
- Microsoft Excel
RN Unit Manager
FutureCare —Annapolis, MD
- $94,000 - $102,000 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- Tuition reimbursement
- Paid time off
Quick Apply
RN Bilingual Case Manager - Breast & Cervical Cancer Outpatient Program
MedStar Health —Baltimore, MD
- $86,000 a year
- Full-time
- Background check
- Spanish
- Nursing
Quick Apply
RN Unit Manager- FT Days
FutureCare —Baltimore, MD
- $94,000 - $102,000 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- Tuition reimbursement
- Paid time off
Quick Apply
14d
Health Home RN Care Manager
Arundel Lodge, Inc. —Edgewater, MD
- $30 - $32 an hour
- Overtime
- Nursing
- Vital signs
- RN License
Quick Apply
RN Unit Manager
FutureCare —Randallstown, MD
- $94,000 - $102,000 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- Tuition reimbursement
- Paid time off
Quick Apply
Registered Nurse Supervisor Weekend and Evenings (RN) Full Time $5000 Retention Bonus
Stadium Place Nursing & Rehab Center —Baltimore, MD
- $40 - $45 an hour
- Full-time
- Vital signs
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
RN Night Supervisor Sign on Bonus Available
Largo Nursing and Rehabilitation Center —Upper Marlboro, MD
- $40 - $43 an hour
- Full-time
- Nursing
- Skilled nursing facility
- RN License
- Health insurance
- Dental insurance
Quick Apply
RN House Supervisor Weekend 10K Bonus
Largo Nursing and Rehabilitation Center —Upper Marlboro, MD
- $40 - $45 an hour
- Full-time
- Skilled nursing facility
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
RN Unit Manager 10k Retention Bonus available
Largo Nursing and Rehabilitation Center —Upper Marlboro, MD
- $45 - $49 an hour
- Full-time
- Skilled nursing facility
- RN License
- Mid-level
Quick Apply
RN Shift Supervisor - Every Other Weekend 7p-7a
FutureCare —Baltimore, MD
- $40.50 - $56.00 an hour
- Rotating weekends
- CPR Certification
- Nursing
- RN License
- Tuition reimbursement
- Paid time off
Quick Apply
Registered Nurse Weekend Supervisor
Hyattsville Nursing and Rehabilitation Center —Hyattsville, MD
- $45.00 - $47.50 an hour
- Part-time
- CPR Certification
- Nursing
- Skilled nursing facility
- Flexible schedule
Quick Apply
14d
RN Unit Manager Position
Crescent Cities Nursing and Rehabilitation Center —Riverdale Park, MD
- $45 - $47 an hour
- Full-time
- RN License
- Mid-level
- Rehabilitation center
- 401(k)
- Flexible spending account
Quick Apply
RN Unit Manager- FT Days
FutureCare —Baltimore, MD
- $94,000 - $112,000 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- Tuition reimbursement
- Paid time off
RN Weekend Supervisor
South River Rehabilitation and Wellness Center —Edgewater, MD
- $44 - $50 an hour
- Full-time
- RN License
- Mid-level
- In-person
- Health insurance
- 401(k)
Quick Apply
3d

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RN Manager Grievances & Appeals

MedStar Health -
Columbia, MD

Quick Apply

Job Details

Full-time
$102,606 - $196,996 a year
7 days ago

Qualifications

Nursing
RN License
Supervising experience
Bachelor's degree
Case management
Utilization management
Resource utilization in healthcare
Bachelor's degree in nursing
Certified Case Manager
General management
Hospital experience
Nursing

Full Job Description

About this Job: General Summary of Position
Responsible for day to day oversight and management of Intake Clinical Appeals Claims Appeals Complaints Grievances and Intake functions. The Manager of Appeals Complaints and Grievances will be dedicated to delivering service and operational excellence through a focus on continuous improvement in the areas of contribution competencies and performance of the Intake Appeals Complaints and Grievances team. This role will be tasked with overseeing intake the development and operational execution of all appeals (clinical and non-clinical) complaints and grievance processes in line with regulatory standards while enhancing quality and effectiveness. Additionally the role will need to utilize advanced technical knowledge to resolve complex issues. This involves setting objectives creating policies and procedures determining approaches allocating resources and managing inventory.

Primary Duties and Responsibilities

Oversees and provides direction for Intake Appeals (Clinical and Claims) Retrospective Review Emergency Room Review and Customer Service/Complaints/Grievances for all lines of business.
Oversees and analyzes critical data and reporting as required by MedStar Family Choice for areas of responsibility. Ensures appropriate data collection and timely submission.
Develops and contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Ensures compliance with hospital/facility policies and procedures and governmental/accreditation regulations.
Actively participates with annual strategic planning objectives for MedStar Family Choice. Initiates innovative ideas and programs to improve quality while maintaining or reducing medical expense.
Provides oversight to ensure that retrospective events appeals and complaints/grievances timeframes are in compliance with NCQA EQRO State of Maryland District of Columbia Federal and any other applicable standards.
Maintains working knowledge of MFC authorization rules for MD and DC and facilitates appropriate training to ensure that MFC associates practitioners facilities and vendors are aware of authorization rules.
Acts as the clinical liaison with IT and subject matter expert for Appeals Grievances and Customer Service with respect to the clinical software system. Maintains close affiliation with the support service team to ensure the system operations meet departmental functions troubleshoots issuers coordinates testing for system upgrades and coordinates appropriate training for associates. Acts as a resource to staff using the software.
Oversees the selection orientation training program and assignment of new and current associates. Maintains up to date training manuals for assigned departments.
Develops standards of performance evaluates performance and conducts performance management planning. Initiates or makes recommendations for personnel actions. Maintains ongoing communication with subordinates to review programs provide feedback discuss new developments and exchanges information.
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.
Performs other duties as assigned.

Minimal Qualifications
Education

Bachelor's degree in Nursing required

Experience

3-4 years Utilization management experience required and
5-7 years Diverse clinical experience in a hospital or medical setting required and
1-2 years 2 years supervisory experience required
Additional experience with appeals and grievances preferred

Licenses and Certifications

RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the State of Maryland upon hire and valid RN licensure in the District of Columbia (DC) prior to start date in position. Upon Hire required and
CCM - Certified Case Manager Active Certified Case Manager (CCM) or CCM certification within 1 Year required

Knowledge Skills and Abilities

Excellent verbal and written communication skills.
Proficient in Microsoft Word Excel and PowerPoint.

This position has a hiring range of : USD $102,606.00 - USD $196,996.00 /Yr.

Work Location: Hybrid remote in Columbia, MD 21044

Quick Apply

Refine Your Search

nursing supervisor jobs in pasadena md

RN Manager Grievances & Appeals

Nurse Care Management, Manager

Care Manager (Remote)

Case Manager Registered Nurse- Field

OB Care Manager

RN Care Manager

RN Unit Manager

RN Bilingual Case Manager - Breast & Cervical Cancer Outpatient Program

RN Unit Manager- FT Days

Health Home RN Care Manager

RN Unit Manager

Registered Nurse Supervisor Weekend and Evenings (RN) Full Time $5000 Retention Bonus

RN Night Supervisor Sign on Bonus Available

RN House Supervisor Weekend 10K Bonus

RN Unit Manager 10k Retention Bonus available

RN Shift Supervisor - Every Other Weekend 7p-7a

Registered Nurse Weekend Supervisor

RN Unit Manager Position

RN Unit Manager- FT Days

RN Weekend Supervisor

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