Utilization Management Specialist II - Remote

Overview

The Utilization Management Specialist II plays a crucial role in assessing patient needs for care, ensuring appropriate levels of care are met, and collaborating with medical teams and payers to manage cases effectively.

In Short

• Provides utilization review and denials management for assigned patient cases.
• Utilizes nationally recognized care guidelines to assess patient needs.
• Interacts with case managers, medical teams, and payers.
• Requires licensure as a Registered Nurse or equivalent healthcare license.
• Minimum of 12 months experience in case management or utilization management is required.
• Located in a vibrant academic medical center in downtown Baltimore.
• Focuses on enhancing patient care and advancing nursing science.
• Confidential handling of information according to EEO guidelines.
• Competitive compensation package with benefits.
• Opportunity to work in a Magnet®-designated facility.

Requirements

• Licensure as a Registered Nurse or equivalent in Maryland.
• 12 months experience in case management or utilization management.

Benefits

• Comprehensive benefits package available.
• Opportunity for professional growth in a recognized medical center.