Utilization Management CoordinatorNE

University of Maryland Medical System; Glen Burnie (MD); On-site; USD 55,944 - 83,978; Full time

Job summary

University of Maryland Medical System (UMMS) is seeking an Utilization Management Coordinator to support care management. The role collaborates with hospital teams, insurers, and regulators to ensure regulatory compliance and maximize reimbursement while minimizing denials.

The ideal candidate is a Maryland-licensed registered nurse with BSN preferred and at least three years of relevant clinical experience.

Qualifications

• Education: Graduation from an accredited nursing education program approved by the Board of Nursing or substantially equivalent in Maryland; Currently licensed as a Registered Nurse in Maryland.
• Experience: Three (3) years of relevant clinical experience required; ongoing education and certification to stay current with hospital utilization and case management.

Responsibilities

• Collaborate with the hospital team, the insurance provider, and regulatory agencies to ensure compliance with regulatory and reimbursement requirements and maximize reimbursement while minimizing denials.

Education

Maryland Registered Nurse license

BSN (preferred)

Job description

Job Description

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 Maryland required, BSN preferred.

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

Compensation

• Pay Range: $40.61 - $60.96
• Other Compensation (if applicable): Not specified
• Review the 2025-2026 UMMS Benefits Guide

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

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