15 utilization review case manager jobs at 11 companies in Maryland
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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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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
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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Supervisor, Utilization Management
Phoenix or Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming
$91k-$107k/yr RemoteFull Time
3+ YOE3+ MgmtCurrent RN license, 3+ years healthcare experience, 3+ years supervisory experience, 2+ years utilization review/case management, U.S. citizenship and favorable DoD background investigation required.
InterQual, ICD, DSM, CPT, HCPCS, American Dental codes, Microsoft Office, Microsoft Word, Microsoft Outlook, TriWest Intranet
5d
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RN Case Manager
New Orleans or Colorado or California or Hawaii or Illinois or Maine or Maryland or Massachusetts or Minnesota or New Jersey or New York or Vermont or Washington or District of Columbia
OnsiteFull Time
Graduate of an accredited nursing school with a current RN license and American Heart Association BLS. Hospital discharge planning, case management, or utilization review experience and CCM or ACM certification are preferred.
1mo
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Supervisor, Utilization Management
Phoenix or Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming
$91k-$107k/yr RemoteFull Time
3+ YOE3+ MgmtActive RN license, 3+ years healthcare experience, 3+ years supervisory experience, 2+ years utilization review/case management, U.S. citizenship and favorable DoD background investigation required; CCM/HCQM preferred.
Microsoft Office, Microsoft Word, Microsoft Outlook, InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Current Procedural Terminology, Healthcare Common Procedural Coding System
1mo
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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
3w
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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
3w
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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
5d
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Registered Nurse (RN) - Admissions Case Coordinator
Salisbury, Maryland, United States
$39-$60/hr OnsiteFull Time
1+ YOECurrent RN license required; 1–3 years of acute care hospital experience required. Bachelor's degree, home health, case management, utilization review, and discharge planning experience preferred.
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
2mo
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Clinical Document Integrity Specialist - Part Time - Remote (Mooresville, NC, US, 28117)
Mooresville or Alabama or Arizona or California or Colorado or Connecticut or Delaware or Florida or Georgia or Hawaii or Illinois or Indiana or Iowa or Kentucky or Louisiana or Maine or Maryland or Massachusetts or Michigan or Missouri or Montana or New Hampshire or New Jersey or New York or North Carolina or Ohio or Oregon or Pennsylvania or South Carolina or Tennessee or Texas or Virginia or Washington or District of Columbia
RemotePart Time
3+ YOEBSN/PA/NP/Doctorate in a medically related field required; 3+ years progressive acute care experience; prior case management/utilization review preferred; licensed as RN/PA/NP/MD preferred; CCDS/CCS/CDIP preferred; strong communication, critical thinking, and computer skills.
ICD-9, ICD-10, PCS, DRG, SOI/ROM, CDI database, AHIMA Practice Brief
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