Utilization Review RN
Requisition #: 188268
Location: Johns Hopkins Health Care, Hanover, MD 21076
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: July 19, 2019
Johns Hopkins employs more than 20,000 people annually across our health system. When joining Johns Hopkins, you became 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. Great careers continually advance here.
Responsible for utilization review and interdisciplinary coordination with a variety of providers, the most cost effective, quality care for managed health care enrollees in different lines of business. Specific activities and frequency of those activities will vary within the area of assignment. The Utilization Review RN (URN) actively monitors the care given in a variety of settings, acute hospital, sub-acute hospital, and acute rehabilitation facility. Proactive discharge planning for every hospitalized member is also required of this position. The URN is a member of administrative and clinical teams in the area of assignment. Clinical knowledge is maintained and updated.
- Work requires incumbent to be a graduate of an accredited school of nursing; BSN preferred.
- Knowledge of health care and managed care delivery systems. This includes standards of medical practice; insurance benefit structures and related legal/ medical issues; and utilization management and quality improvement processes.
- Current Registered Nurse licensure in the state of Maryland
- Certification in Case Management (CCM) or Utilization Management preferred
- Minimum of three years of nursing experience which includes a minimum of three years in an acute care hospital setting
- Minimum two years management experience, preferably in the managed care environment.
Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity,sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.
Johns Hopkins Medicine.