Current jobs related to Utilization Management Nurse - Annapolis - Luminis Health
-
Utilization Management Nurse
1 day ago
Luminis Health AnnapolisUtilization Management Nurse - Emergency Department (onsite role) · Anne Arundel Medical Center, Annapolis, MD · Full Time - Day shift (three - 12 hour shifts, rotating weekends) · Status: Non-Exempt · Position Objective: Conducts concurrent and retrospective chart review fo ...
-
Nurse Case Manager
1 day ago
Incredible Health Annapolis permanentHospitals on Incredible Health are actively hiring and accepting applications in the Annapolis, MD area for the following position: Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly encouraged to apply: Clinical pathway, Navigator, or Util ...
-
RN Nursing Unit Manager
1 day ago
CommuniCare Family of Companies EdgewaterA Deeper Compassion, For A Higher Purpose · Nurses are at the heart of our world-class, patient-centered standard of care. They go the extra mile to make a lasting difference in the lives of our residents and their families. · South River Healthcare Center is seeking an RN Nursin ...
-
RN Registered Nurse, New Management
4 hours ago
CommuniCare Family of Companies EdgewaterA Deeper Compassion, for a Higher Purpose · Nurses are at the heart of our world-class, patient-centered standard of care. They go the extra mile to make a lasting difference in the lives of our residents and their families. We encourage you to make a difference with a team that ...
-
Nurse Manager
1 day ago
Incredible Health Silver Spring permanentHospitals on Incredible Health are actively hiring and accepting applications in the Silver Spring, MD area for the following position: Nurse Manager - Obstetric / Labor & Delivery. Nurses with experience in any of the following areas are strongly encouraged to apply: Assistant N ...
-
Nurse Manager
1 day ago
State of South Carolina ColumbiaJob Summary · This position is located at the Department of Mental Health, Bryan Psychiatric Hospital Campus. As a Nurse Manager III, you will coordinate and implement the Nursing Program on a designated Lodge/Area with 24-hour Clinical Management for assigned lodge/area. · The r ...
-
Nurse Manager
1 day ago
Johns Hopkins Medicine Baltimore Full timeYou belong here · The Johns Hopkins Hospital has been at the forefront of discovery, innovation and medical advances for over 125 years. Our reputation for excellence has earned us a spot on U.S. News & World Report's Best Hospitals list for over two decades. We believe that the ...
-
Nurse Manager
1 day ago
Incredible Health Baltimore permanentHospitals on Incredible Health are actively hiring and accepting applications in the Baltimore, MD area for the following position: Nurse Manager - Mother Baby. Nurses with experience in any of the following areas are strongly encouraged to apply: Assist in c-sections, Assistant ...
-
nurse manager
1 day ago
LifeBridge Health BaltimorePOSITION SUMMARY: · The Manager-Patient Care Services oversees the behavioral health/inpatient psychiatric units at Sinai Hospital, known as MP1 and MP2. The nurse manager ensures safe, age-appropriate patient care during unit operation hours. As a role model, advisor, resource, ...
-
Nurse Manager
1 day ago
Johns Hopkins Medicine BaltimoreJob Description · Job Description · You belong here · The Johns Hopkins Hospital has been at the forefront of discovery, innovation and medical advances for over 125 years. Our reputation for excellence has earned us a spot on U.S. News & World Report's Best Hospitals list for ov ...
-
Nurse Manager
1 day ago
Incredible Health Columbia permanentHospitals on Incredible Health are actively hiring and accepting applications in the Columbia, MD area for the following position: Nurse Manager - Transplant. Nurses with experience in any of the following areas are strongly encouraged to apply: Assistant Nurse Manager, CNO, Char ...
-
Nurse Manager
1 day ago
Jobleads-US BaltimoreYou belong here · The Johns Hopkins Hospital has been at the forefront of discovery, innovation and medical advances for over 125 years. Our reputation for excellence has earned us a spot on U.S. News & World Report's Best Hospitals list for over two decades. We believe that the ...
-
Nurse Manager
1 day ago
Johns Hopkins Medicine baltimoreYou belong here The Johns Hopkins Hospital has been at the forefront of discovery, innovation and medical advances for over 125 years. Our reputation for excellence has earned us a spot on U.S. News & World Report's Best Hospitals list for over two decades. We believe that the co ...
-
Nurse Manager
1 day ago
LifeBridge Health BaltimoreNurse Manager - Patient Care Services - Sinai Hospital - ER7 · Baltimore, MD · SINAI HOSPITAL · ER-7 NURSING · Full-time w/Weekend Commitment - Day shift - Hours Vary · RN Leader · 87849 · $49.02-$75.98 Experience based · Posted: · February 8, 2025 · <-- end .job__details-list ...
-
Manager Nursing
1 day ago
SCA Health ColumbiaKey Overview: · We are a team of 11,000 dedicated professionals at SCA Health, serving over 1 million patients annually and supporting physician specialists across various aspects of patient care. Our goal is to deliver high-quality outcomes, better experiences for patients and p ...
-
Nurse Manager
1 day ago
Medical University of South Carolina Columbia Full timeJob Title: Emergency Department Nurse Manager · The Emergency Department Nurse Manager reports to the Director/Service Line Administrator. · This role ensures the provision of high-quality patient care in collaboration with other healthcare professionals in a respectful and adapt ...
-
Nurse Manager
1 day ago
University of Maryland Medical System BaltimoreJob Title · A Summary of the Position in 50 Words: · The Nurse Manager is a Registered Nurse accountable for ensuring safe, effective patient care on a designated unit under limited supervision. · Job Description · The Nurse Manager serves as the link between the Hospital's Visio ...
-
Nurse Manager
1 day ago
Mary's Center Hyattsville· Position Summary · The Nurse Manager's role is to assist and support the clinical team in providing quality healthcare services to Mary's Center patients and guarantee an effective link with other community agencies. The Nurse Manager provides leadership for their health cent ...
-
Nurse Manager
1 day ago
Resiliency LLC Baltimore Full timeJob Description · Job Description · The Manager of Oncology Services will provide ongoing administrative coordination and management of the services and activities, which comprise the Infusion Center, Lab, Medical Oncology Physician Practice Operations and liaison to scheduling, ...
-
Nurse Manager
1 day ago
Prisma Health COLUMBIAInspire Health. Serve with Compassion. · Be the Difference in Patient Care. · Job Summary · A clinical leader is needed to direct and supervise clinical functions and activities of the department or group of practices. This role involves implementing and interpreting policies, st ...
-
Nurse Manager
1 day ago
Resiliency BaltimoreThe Manager of Oncology Services will provide ongoing administrative coordination and management of the services and activities, which comprise the Infusion Center, Lab, Medical Oncology Physician Practice Operations and liaison to scheduling, registration and pharmacy services. ...
- Chart Review:
- Denial Management:
- Care Coordination:
- Process Improvement Initiatives:
- Bachelor's of Science in Nursing or Associate's degree in Nursing with equivalent experience. BSN must be achieved within 5 years of start date in the role.
- Three years of clinical nursing in an acute care hospital setting.
- Current RN license from Maryland Board of Nursing.
Utilization Management Nurse - Annapolis - Luminis Health

Description
Utilization Management Nurse - Emergency Department
This is an onsite role at Anne Arundel Medical Center in Annapolis, MD.
Job Summary:
We are seeking a skilled Utilization Management Nurse to conduct concurrent and retrospective chart review for clinical, financial, and resource utilization information. The successful candidate will provide intervention and coordination to decrease avoidable delays and denial of payment.
Essential Job Duties:
The nurse will review the medical record by applying utilization review criteria to assess clinical, financial, and resource utilization. This includes entering clinical review in EPIC, maintaining close communication with external reviews, care coordinators, and providers, and reconciling and recording days authorized in EPIC.
The nurse will monitor and identify patterns or trends in utilization management, monitor potential and actual denials, and collaborate with care coordinators for any follow-up necessary. They will also document actions taken to avoid denial and assist Care Coordinators in communicating with patients denied hospital days to work toward resolution and discharge.
The nurse will collaborate with Care Coordinators to achieve optimal and efficient patient outcomes while decreasing length of stay, avoidable delays, and denied days. They will utilize Physician Advisors and administrative personnel for unresolved issues, identify opportunities for expedited appeals, and collaborate with Care Coordinators and Physician Advisors to resolve payer issues.
The nurse will participate in nursing unit and department clinical outcome projects as well as process improvement initiatives of care management.
Requirements:
License/Certifications:
Working Conditions:
There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens.
-
Utilization Management Nurse
Luminis Health- Annapolis
-
Nurse Case Manager
permanent Incredible Health- Annapolis
-
RN Nursing Unit Manager
CommuniCare Family of Companies- Edgewater
-
RN Registered Nurse, New Management
CommuniCare Family of Companies- Edgewater
-
Nurse Manager
permanent Incredible Health- Silver Spring
-
Nurse Manager
State of South Carolina- Columbia
-
Nurse Manager
Full time Johns Hopkins Medicine- Baltimore
-
Nurse Manager
permanent Incredible Health- Baltimore
-
nurse manager
LifeBridge Health- Baltimore
-
Nurse Manager
Johns Hopkins Medicine- Baltimore
-
Nurse Manager
permanent Incredible Health- Columbia
-
Nurse Manager
Jobleads-US- Baltimore
-
Nurse Manager
Johns Hopkins Medicine- baltimore
-
Nurse Manager
LifeBridge Health- Baltimore
-
Manager Nursing
SCA Health- Columbia
-
Nurse Manager
Full time Medical University of South Carolina- Columbia
-
Nurse Manager
University of Maryland Medical System- Baltimore
-
Nurse Manager
Mary's Center- Hyattsville
-
Nurse Manager
Full time Resiliency LLC- Baltimore
-
Nurse Manager
Prisma Health- COLUMBIA
-
Nurse Manager
Resiliency- Baltimore