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Outpatient Utilization Review Nurse

Job Attributes

Job Id:

17446

Job Category:

Clinical & Life Sciences

Job Location:

Baltimore, MD  20810

Security Clearance:

No Clearance

Business Unit:

Piper Companies

JOB DESCRIPTION

Piper Clinical Solutions is in search of a driven Outpatient Utilization Review Nurse in Baltimore, MD to support a local healthcare service provider.

Responsibilities for the Outpatient Utilization Review Nurse:

  • Provide utilization review and coordination to a wide variety of medical facilities for outpatient services which will vary per assignment
  • Ensure patients receive necessary, appropriate, and adequate care based on review of related medical information
  • Responsible for concurrent reviews to ensure accurate and appropriate clinical documentation
  • Holds weekly meetings with associated facility Medical Directors
  • Coordinates outpatient services per case

Requirements for the Outpatient Utilization Review Nurse:

  • 4+ years of acute care experience required
  • Minimum 1 year managed care/utilization review required
  • Equivalent experience plus Associates in Nursing related field required (BSN preferred)
  • Experience with cost regulation and insurance claims payment preferred
  • Current MD RN license required
  • Associates in Nursing related field required (BSN preferred)

Compensation for the Outpatient Utilization Nurse:

  • Salary up to $85,000 based on qualification of skills
  • Benefits include Health/Dental/Vision coverage, PTO, Merit increases, Continued Education Assistance, 401K

 

Please send all qualified resumes to: dmanley@pipercompanies.com

 

Keywords:

Outpatient, utilization review, RN, registered nurse, acute care, medical, healthcare, concurrent review, health insurance, nurse, Advantage MD, USFHP, case manager, CCM, medicare, medicaid, post-pay, tri-care, MCO, continued stay, short stay, discharge, utilization

 

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Job Id:

17446

Job Category:

Clinical & Life Sciences

Job Location:

Baltimore, MD  20810

Security Clearance:

No Clearance

Business Unit:

Piper Companies