Top 17 Clinical documentation & utilization review nurses Jobs in Annapolis, Md

Utilization Review Nurse - Managed Care
Johns Hopkins Health Plans —Hanover, MD
- $39.64 - $61.45 an hour
- Full-time
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
12d
Utilization Reviewer
University of Maryland Medical System —Largo, MD
- $40.61 - $60.96 an hour
- Full-time
- Nursing
- RN License
- Hospital
Utilization Review Case Manager - Partial Hospitalization Program
Luminis Health —Lanham, MD
- $81,967.12 - $122,950.68 a year
- Part-time
- Bachelor of Science
- Mid-level
- Bachelor's degree
- AD&D insurance
- Paid holidays
2d
Medical Review Nurse- Medicare
Peraton —Linthicum, MD
- $66,000 - $106,000 a year
- Remote
- Nursing
- RN License
- Research
- Health savings account
- Paid holidays
8d
Clinical Analyst
Global Alliant Inc —Baltimore, MD
- Full-time
- Remote
- Mid-level
- Computer skills
- Communication skills
Quick Apply
Utilization Management Nurse
Luminis Health —Annapolis, MD
- $34 - $55 an hour
- Full-time
- Nursing
- RN License
- Bachelor of Science
- AD&D insurance
- Paid holidays
Clinical Registry Coordinator
University of Maryland Medical System —Baltimore, MD
- Full-time
- Nursing
- Surgery
- RN License
HIM Clinical Document Specialist, UMMC
University of Maryland Medical System —Baltimore, MD
- Full-time
- Medicine
- RN License
- Inpatient
Medical Review Nurse III
RELI GROUP INC —Baltimore, MD
- $80,000 - $95,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
Quick Apply
Prospective Payment System Coordinator
University of Maryland Medical System —Baltimore, MD
- Full-time
- Nursing
- RN License
- Word processing
MDS Coordinator / RN Assessment Coordinator
Ginger Cove —Annapolis, MD
- $90,000 - $100,000 a year
- Full-time
- CPR Certification
- Skilled nursing facility
- RN License
- Health insurance
- Dental insurance
Quick Apply
Clinical Reimbursement Coordinator, RN
Doctors Community Rehab Ctr —Lanham, MD
- $45 - $52 an hour
- Full-time
- Nursing
- Skilled nursing facility
- RN License
- Disability insurance
- Dental insurance
RN MDS Coordinator RNAC
Villa Rosa Nursing and Rehabilitation Center —Mitchellville, MD
- $100,000 - $105,000 a year
- Full-time
- RN License
- Mid-level
- Reliable transportation
- Loan repayment program
- Disability insurance
Medicaid Medical Review RN (Medical Reviewer III)
CoventBridge Group —United States
- $78,000 - $85,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- Paid holidays
- Disability insurance
1d

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Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
Clinical Quality Auditor Contingent/IRP
The Ohio State University Wexner Medical Center —Columbus, OH
The Clinical Quality Auditor will assist to identify and facilitate opportunities for improvement in the delivery of patient care related to clinical care,…

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clinical documentation & utilization review nurses jobs near annapolis, md

Utilization Review Nurse - Managed Care

Johns Hopkins Health Plans -
Hanover, MD

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Job Details

Full-time
$39.64 - $61.45 an hour
12 days ago

Benefits

Paid holidays
Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Vision insurance
403(b)

Qualifications

Nursing
RN License
Managed care organization experience
Utilization management
Resource utilization in healthcare
Acute care experience
Nursing

Full Job Description

Requisition #:

673794

Location:

Johns Hopkins Health Plans, Hanover, MD 21076

Category:

Nursing

Schedule:

Day Shift

Employment Type:

Full Time

Excel. Empower. Advance. Shine. Belong. Explore. Flourish. Champion.

Make It Happen At Hopkins!

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. JHHP is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP has become a leader in provider-sponsored health plans and is poised for future growth.

About this position:

Work Monday - Friday, the core business hours are 8:00 AM - 5:00 PM

As 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. Your in-depth knowledge of the appropriate levels of care makes you a valuable resource to our members when they are in need.

What you’ll do:

Monitor the appropriateness of care received by plan members in a variety of settings
Evaluate member benefits and medical criteria to determine authorization of services
Communicate authorization and/or denial of covered services with all parties involved
Initiate discharge planning of members

What awaits you:

Work-life balance - This is a remote role! Candidates in the following approved states will be given priority: MD, DC, VA, PA, DE, FL
Medical, Dental, and Vision Insurance.
403B Savings Plan w/employer contribution.
Paid Time off & Paid holidays.
Employee and Dependent Tuition assistance benefits.
Health and wellness programs and MORE!

What you’ll bring:

Understanding of managed care delivery systems and utilization management
Knowledge and expertise in utilizing various criteria sets (i.e. InterQual)
Ability to negotiate and resolve conflicts with external customers.
Unencumbered Registered Nurse (RN) license in Maryland (or Compact state)

3+ years’ experience as an acute care RN
1+ years’ experience in Managed Care/Utilization Review is required

Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home.

Salary Range: Minimum 39.64/hour - Maximum 61.45/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

The Hospital reserves the right to modify employee schedules as needed.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

Johns Hopkins Health System and its affiliates are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Apply Now

Refine Your Search

clinical documentation & utilization review nurses jobs in annapolis, md

Utilization Review Nurse - Managed Care

Utilization Reviewer

Utilization Review Case Manager - Partial Hospitalization Program

Medical Review Nurse- Medicare

Clinical Analyst

Utilization Management Nurse

Clinical Registry Coordinator

HIM Clinical Document Specialist, UMMC

Medical Review Nurse III

Prospective Payment System Coordinator

MDS Coordinator / RN Assessment Coordinator

Clinical Reimbursement Coordinator, RN

RN MDS Coordinator RNAC

Medicaid Medical Review RN (Medical Reviewer III)

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