Top 40 Utilization review nurse Jobs in Hanover Md

RN Inpatient Case Manager Part-Time ( Emergency Dept )
MedStar Health —Olney, MD
- $89,065 - $162,801 a year
- Part-time
- Acute care
- Nursing
- Microsoft Excel
Clinical Medical Review Nurse (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $67,320 - $133,705 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- 401(k)
Quick Apply
1d
Utilization Review Nurse (Registered Nurse CI)
State of Maryland - MDH Education and Training —Catonsville, MD
- $87,253 - $137,603 a year
- Online Application
- Hybrid work
- RN License
- Residential
- Entry level
7d
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
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
4d
Utilization Management CoordinatorNE
University of Maryland Medical System —Glen Burnie, MD
- $40.61 - $60.96 an hour
- Full-time
- Nursing
- RN License
- Hospital
8d
Nurse CARE Manager, Wellness Center & Case Management
Marriott International, Inc —Bethesda, MD
- $84,000 - $147,500 a year
- Full-time
- CPR Certification
- Nursing
- Medication administration
- Commuter assistance
- Paid parental leave
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
Case Manager
Mercy Medical Center —Baltimore, MD
- $36.92 - $66.46 an hour
- Full-time
- Nursing
- RN License
- Hospital
- 403(b) matching
- Paid holidays
13d
Utilization Management Nurse
Luminis Health —Annapolis, MD
- $34 - $55 an hour
- Full-time
- Nursing
- RN License
- Bachelor of Science
- AD&D insurance
- Paid holidays
Telephonic Case Manager I
CorVel Corporation —Nottingham, MD
- $63,739 - $95,264 a year
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
Travel RN - Case Management/Utilization Review - Case Management
American Traveler —Silver Spring, MD
- $2,917 a week
- 8 hour shift
- Acute care
- Nursing
- RN License
Quick Apply
RN Case Manager
Johns Hopkins Bayview Medical Center —Baltimore, MD
- Full-time
- Nursing
- Surgery
- RN License
- Health insurance
- Opportunities for advancement
Medical Field Case Manager
Enlyte —Baltimore, MD
- $79,000 - $95,000 a year
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
11d
Care Manager, RN
University of Maryland Medical System —Towson, MD
- Full-time
- RN License
- Hospital
- Inpatient
PRN Care Manager (RN)
University of Maryland Medical System —Towson, MD
- Full-time
- Nursing
- Hospital
- Inpatient
9d
Prospective Payment System Coordinator
University of Maryland Medical System —Baltimore, MD
- Full-time
- Nursing
- RN License
- Word processing
9d
Case Manager II
Children's National Hospital —Washington, DC
- $87,172.80 - $145,267.20 a year
- Weekends as needed
- Nursing
- RN License
- Customer service
- Commuter assistance
- AD&D insurance
Clinical Review Clinician
Gaudenzia —Washington, DC
- $75,000 - $85,000 a year
- 8 hour shift
- LMFT
- Writing skills
- LPC
- Tuition reimbursement
Quick Apply
21h
Registered Nurse (RN)
Kensington Senior Living, LLC —Kensington, MD
- $40 - $45 an hour
- Weekends as needed
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quick Apply

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utilization review nurse jobs near hanover md

RN Inpatient Case Manager Part-Time ( Emergency Dept )

MedStar Health -
Olney, MD

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Job Details

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

Qualifications

RN License
Data entry
Associate's degree
Clinical data analysis
Associate Degree in Nursing

Full Job Description

About this Job:

***Work days are set for Wednesdays and Thursdays each week, experienced utilization review candidates highly preferred for this dual discharge planner/UR role***

General Summary of Position
Serves as a member of the Case Management Team and applies RN clinical expertise and medical appropriateness to care coordination and discharge planning. Facilitates the delivery of quality cost effective patient-centered care from pre-admission through post-discharge timeframe. Ensures the care is designed to meet individualized patient outcomes. Monitors the care and services delivered to selected patient populations during the acute hospital stay promotes effective case management and utilization of resources and works to achieve optimal clinical and resource outcomes for the acute and post-hospital phases of care.

Primary Duties and Responsibilities

Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
Collaborates with the multidisciplinary health care team to develop and coordinate the plan of care.
Communicates with patient family and/or significant other health care team external case manager community resources and facility to address appropriate issues and patient/family goals.
Demonstrates the ability to develop a plan of care that addresses needs across the continuum; have an intervention for problems identified; develop long- and short-term goals with specific time frames for resolution; identify specific services to be provided in the care plan; include the family/care-giver in the plan of care; and show life planning contingencies such as power of attorney and/or advance directives.
Evaluates and documents the patient's response to the plan of care and achievement of outcomes. Makes recommendations for modifications to the plan of care as indicated. Adheres to all policies and procedures regarding documentation and confidentiality of information.
Maintains knowledge of regulatory agencies' requirements necessary criteria for admission to various care settings and Medicare's/Medicaid's reimbursement methods for different levels of care.
Manages a caseload of patients. Identifies essential resources needed to implement the plan of care.
Manages own professional growth in the area of managed care care management other health care financial trends clinical practice and research.
Manages patient care according to multidisciplinary plan of care and/or managed care contracts by directing decision making and identifying and managing barriers that impact on patient care outcomes.
Participates in Performance and Service Improvement teams. Assists in program evaluation through customer service surveys LOS data analysis charge/discharge data comparison to state averages and best practice/benchmark data.
Performs a comprehensive assessment in collaboration with interdisciplinary team to identify patient-specific problems and needs related to diagnosis treatment including psychosocial and financial concerns as well as medical.

Minimal Qualifications
Education

Associate's degree in Nursing (ADN) required
Bachelor's degree in Nursing (BSN) preferred

Experience

2-3 years of clinical experience required
1-2 years case management experience preferred

Licenses and Certifications

RN - Registered Nurse - State Licensure and/or Compact State Licensure in the District of Columbia or Maryland depending on work location required
CCM - Certified Case Manager preferred

Knowledge Skills and Abilities

Ability to use computer to enter and retrieve data.
Working knowledge of Microsoft Word Excel and PowerPoint applications.
Effective verbal and written communication skills.
Must be able to run and analyze departmental productivity reports.
Excellent interpersonal skills required.

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

Apply Now

Refine Your Search

utilization review nurse jobs in hanover md

RN Inpatient Case Manager Part-Time ( Emergency Dept )

Clinical Medical Review Nurse (Remote)

Utilization Review Nurse (Registered Nurse CI)

Care Manager (Remote)

Utilization Review Nurse - Managed Care

Utilization Management CoordinatorNE

Nurse CARE Manager, Wellness Center & Case Management

Medical Review Nurse III

Case Manager

Utilization Management Nurse

Telephonic Case Manager I

Travel RN - Case Management/Utilization Review - Case Management

RN Case Manager

Medical Field Case Manager

Care Manager, RN

PRN Care Manager (RN)

Prospective Payment System Coordinator

Case Manager II

Clinical Review Clinician

Registered Nurse (RN)

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