Remote Utilization Review RN – Managed Care
Johns Hopkins Medicine
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Benefits offered by this job
Job summary
Johns Hopkins Medicine is seeking a Utilization Review Registered Nurse based in Hanover, MD. This full-time role allows you to leverage your clinical expertise to enhance member care through effective monitoring and communication. Your insights on managed care will be essential to the decision-making process.
Join a forward-thinking team advocating innovative approaches to healthcare delivery. Enjoy perks like tuition assistance, work-life balance, and comprehensive insurance benefits while working remotely.
Qualifications
- Deep understanding of managed care delivery systems and utilization management.
- Knowledge of various criteria sets (i.e. InterQual).
- Ability to negotiate and resolve conflicts with external customers.
Responsibilities
- Monitor appropriateness of care received by plan members.
- Evaluate benefits and medical criteria for service authorization.
- Communicate authorization and/or denial of covered services.
Skills
Education
Job description
Johns Hopkins Medicine is seeking a Utilization Review Registered Nurse based in Hanover, MD. This full-time role allows you to leverage your clinical expertise to enhance member care through effective monitoring and communication. Your insights on managed care will be essential to the decision-making process.
Join a forward-thinking team advocating innovative approaches to healthcare delivery. Enjoy perks like tuition assistance, work-life balance, and comprehensive insurance benefits while working remotely.
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