15 utilization review case manager jobs at 9 companies in Gaithersburg, MD
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Utilization Review Case Manager - Partial Hospitalization Program
Annapolis or Bowie or Lanham
$82k-$123k/yr OnsitePart Time
2+ YOEBachelor's degree and two years of utilization review or utilization management experience required. Assesses medical necessity, manages referrals, reviews records, and coordinates with payors.
1w
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Utilization Review Case Manager - Partial Hospitalization Program
Annapolis or Lanham
$82k-$123k/yr HybridPart Time
2+ YOEBachelor's degree and two years of utilization review or utilization management experience. Requires clinical assessment, medical necessity review, authorization, documentation, payer coordination, and appeals experience.
2w
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Utilization Review Nurse (Full-Time)
Towson, Maryland, United States
$68k-$110k/yr OnsiteFull Time
5+ YOEMaryland RN license and BSN, or ASN with enrollment in a BSN program. Requires 5 years acute-care experience, including 2 years utilization review and case management experience.
InterQual, MCG, Electronic Medical Records (EMR)
1mo
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Utilization Reviewer
Largo, Maryland, United States
OnsiteFull Time
Active Maryland RN licensure (or compact eligibility) required; utilization/case management and acute care experience preferred; CPUR preferred; strong communication and analytical skills.
1mo
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Case Manager
Baltimore, Maryland, United States
$37-$66/hr OnsiteFull Time
3+ YOEDegree in nursing and valid RN license required; 3 years clinical experience; medical/surgical, managed care, case management, and utilization review (MCG) experience preferred.
MCG
4w
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Nurse Case Manager
Towson, Maryland, United States
$81k-$122k/yr HybridFull Time
3+ YOEMaryland RN license required, 3-5 years nursing experience, case management/utilization review preferred, BSN preferred, CCM/WCCM/MCRSP certifications preferred, familiarity with Windows, Microsoft Word and Microsoft Excel.
Windows, Microsoft Word, Microsoft Excel
2w
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Case Manager Registered Nurse (674845)
Bethesda, Maryland, United States
$43-$67/hr OnsiteFull Time
2+ YOEBSN required, 2+ years of clinical nursing experience, valid RN license, and basic CPR required. Case management, discharge planning, utilization review, and case management certification preferred.
none
4d
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LPN Case Manager Clinical Authorization
Washington, District of Columbia, United States
$33-$53/hr OnsiteFull Time
1+ YOEMaryland or District of Columbia LPN license required, 1–2 years utilization review experience, and 3–4 years diverse clinical experience. Computer and utilization review knowledge required; office productivity skills preferred.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint
4d
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LPN Case Manager Clinical Authorization
Washington, District of Columbia, United States
$33-$53/hr OnsiteFull Time
1+ YOEValid Maryland or District of Columbia LPN license, 1–2 years of utilization review experience, and 3–4 years of diverse clinical experience. Computer proficiency with Word, Excel, and PowerPoint preferred.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint
2w
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Director of Case Management
Baltimore, Maryland, United States
$58-$104/hr OnsiteFull Time
3+ YOE4+ MgmtMaster's degree required; 3-4 years of experience and progressive leadership preferred, with case management, social work, or utilization review experience required. Maryland or DC RN licensure required.
computer software applications
2w
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Director of Case Management
Baltimore, Maryland, United States
$58-$104/hr OnsiteFull Time
3+ YOE4+ MgmtMaster's degree in nursing, healthcare administration, business administration, or related field; RN licensure in Maryland or DC; 3–4 years of experience in case management, social work, or utilization review; progressive leadership preferred.
computer software applications
2w
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Case Reviewer
Maryland or Columbia
RemoteContract
Bachelor's degree in a related field; strong organization, communication, documentation, data entry, and computer skills. Utilization management, HCBS, and DME knowledge preferred.
E-Verify, Durable Medical Equipment (DME), Home and Community Based Services (HCBS)
1mo
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Nurse CARE Manager, Wellness Center & Case Management
Bethesda, Maryland, United States
$84k-$148k/yr HybridFull Time
5+ YOEActive Maryland RN license, 5+ years nursing experience, BLS/CPR required, occupational health or case management certification (or progress toward), strong clinical assessment and communication skills, ability to perform utilization review and coordinate care.
2w
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Prior Authorization/Financial Analyst II
Washington, District of Columbia, United States
$60k-$102k/yr HybridFull Time
3+ YOEAssociate's degree and 3–4 years of patient billing or insurance claim verification experience required. Claims processing, reimbursement, utilization review, or case management experience preferred.
Medical Records, Electronic Health Records (MR/EHR)
3w
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Nurse Audit Specialist, Remote
Linthicum Heights or Maryland or United States
RemoteFull Time
4+ YOEActive Maryland RN registration, four years of professional nursing experience, and two years of utilization review, quality assurance, or case management experience. Requires audit, communication, negotiation, and computer skills.
MIDAS
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