Evaluating medical necessity and appropriateness of healthcare services, the part-time Maryland Licensed Utilization Management Nurse will conduct clinical reviews, coordinate with healthcare providers, and communicate with payors to secure required authorizations while working remotely. Key responsibilities Review patient medical records to assess the appropriateness of admissions and continued stays Coordinate patient cases and ensure appropriate utilization of resources Communicate with internal and external stakeholders for service authorizations and appeals Required qualifications Bachelor of Science in Nursing (BSN) required Registered Nurse License (RN) required Basic CPR certification required 5+ years of experience in clinical nursing required
Maryland Licensed Utilization Management Nurse in workfromhome at Unknown Company
This position is listed as part time and able to be worked remotely.