Utilization Management CoordinatorNE

University of Maryland Medical System; Glen Burnie (MD); On-site; USD 56,000 - 84,000; Full time

Job summary

UM Baltimore Washington Medical Center, part of the University of Maryland Medical System, seeks a Utilization Management Coordinator. The role collaborates with hospital teams, insurers, and regulators to ensure compliance with reimbursement requirements.

You will maximize reimbursement and minimize denials, with a focus on high-quality care and accurate documentation. Requires Maryland RN license, BSN preferred, and at least three years of relevant clinical experience.

Qualifications

• Three (3) years of relevant clinical experience required.
• Graduation from an accredited nursing program and Maryland RN license.

Responsibilities

• Collaborate with hospital team, insurance providers, and regulatory agencies to ensure compliance with reimbursement requirements.
• Maximize reimbursement and minimize denials through adherence to utilization guidelines.

Education

RN License (Maryland)

BSN preferred

Job description

Job Requirements

Company Description

Experience the highest level of appreciation at UM Baltimore Washington Medical Center named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Workplace in the USA for 2021!As part of the acclaimed University of Maryland Medical System, our facility is one of three ANCC Pathway to Excellence designated hospitals in Maryland. UM BWMC features one of the states busiest emergency departments, as well as a team of experts who care for our community and one another.The University of Maryland Baltimore Washington Medical Center (UMBWMC) provides the highest quality health care services to the communities we serve. Our medical center is home to leading-edge technology, nationally recognized quality, personalized service and outstanding people. We have 285 licensed beds and were home to 3,200 employees and over 800 physicians. Our expert physicians and experienced, compassionate staff are connected to medical practices in the local community as well as at University of Maryland Medical Center in downtown Baltimore. For patients, this means access to high-quality care and research discoveries aimed at improving Marylands health.Our physicians and nursing staff specialize in emergency, acute, medical-surgical and critical care. In addition, our medical center is home to many Centers of Excellence, offering expert outpatient health care.

Job Description

Every other weekend, 8am-4:30pm

General Summary

Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory agencies to assure compliance with regulatory and reimbursement requirements.The position is goal-oriented with a high level of accountability correlated to maximizing reimbursement and minimizing denials.

Mission

All employees are responsible for extending the mission and values of Baltimore Washington Medical Center by dedicating oneself to providing the highest quality healthcare services to the communities we serve.

Reporting Relationships

Reports to the Director of Care Management.

Qualifications

Education:Graduation from an accredited nursing education program approved by the Board of Nursing or found to be substantially equivalent to the programs in Maryland. Currently licensed as a Registered Nurse in the State of Marylandrequired, BSN preferred.

Experience:Three (3) yearsof relevantclinical experience required.Ongoing education, certification, and self development to remain current with industry standards and business objectives related to hospital utilization and case management.

Additional Information

All your information will be kept confidential according to EEO guidelines.

Compensation:

• Pay Range:$40.61 - $60.96
• Other Compensation (if applicable):
• Review the 2025-2026 UMMS Benefits Guide