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Utilization Management Specialist
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Job Description
- Req#: 3743990008159426
Employer Industry: Academic Medical Center
Why consider this job opportunity:
- Salary up to $58.05 per hour
- Opportunity for career advancement and growth within a nationally recognized medical center
- Supportive and collaborative work environment with a focus on enhancing patient care
- Located in a vibrant area of downtown Baltimore, near the Inner Harbor and Camden Yards
- Engaging role that involves working with a diverse medical team and various stakeholders
What to Expect (Job Responsibilities):
- Conduct utilization review and manage denials for an assigned patient caseload
- Utilize nationally recognized care guidelines to assess patient needs for outpatient and inpatient care
- Collaborate with case managers, medical teams, physician advisors, and payers
- Ensure appropriate levels of care are determined based on guidelines and criteria
- Interface with hospital staff to facilitate effective patient care management
What is Required (Qualifications):
- Licensure as a Registered Nurse or equivalent healthcare license in the state of Maryland
- Eligible to practice under Compact state agreements outlined by the Maryland Board of Nursing
- Minimum of 12 months of experience in case management or utilization management
- Strong analytical skills to assess patient care needs effectively
- Excellent communication and interpersonal skills to collaborate with various stakeholders
How to Stand Out (Preferred Qualifications):
- Additional certifications in case management or utilization management
- Experience working in an academic medical center or similar healthcare environment
- Familiarity with electronic health records (EHR) systems
- Strong problem-solving skills in managing complex patient cases
#AcademicMedicalCenter #UtilizationManagement #HealthcareCareers #PatientCare #CareerAdvancement
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