Johns Hopkins Medicine Utilization Review Nurse in Columbia, Maryland

Utilization Review Nurse

Requisition #: 158801

Location: Howard County General Hospital,

Columbia, MD

Category: Nursing

Work Shift: Day Shift

Work Week: Full Time (40 hours)

Weekend Work Required: Yes

Date Posted: Sept. 12, 2017

Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.

The Utilization Review (UR) Nurse is responsible to the Manager, Utilization Management. This individual performs UR and payor management activities, which include prospective and/or retrospective chart and clinical systems review to measure UR issues that affect reimbursement for the patient's hospital stay or visit. Responsibilities include medical record review, communication with third party payors, third party payor initial denials, and special projects which are coordinated and directed by the UR Payor Management Team Leader. May design and initiate special projects as supervised by Manager, Utilization Management.

-Graduate of an accredited school of nursing.

-BSN or Bachelor’s degree in Health Care Related Field experience is required.

-Minimum of three (3) years of relevant clinical experience required, of which demonstrated abilities in the areas of discharge planning, utilization, and quality management is preferred.

-Experience in two or more clinical areas are preferred

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

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. 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.