Registered Nurse Utilization Review
IntelyCare, Inc.
Utilization Management NurseLocation: Partially Remote, with onsite coverage required in Baltimore, MD.Facility: Ascension Saint Agnes HospitalDepartment: Utilization ManagementSchedule: Day-Shift | Full-Time | Monday-Friday 8:00AM-4:30PM | Weekend Rotation once per month.Salary range: $84,094.40- $120,120.00 per yearLife at Ascension: Where Purpose Meets OpportunityAscension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 97,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you'll find an inclusive and supportive environment where your contributions truly matter.Benefits That Help You ThriveComprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA optionsFinancial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insuranceTime to recharge: pro-rated paid time off (PTO) and holidaysCareer growth: Ascension-paid tuition (Vocare), reimbursement, ongoing professional development and online learningEmotional well-being: Employee Assistance Program, counseling and peer support, spiritual care and stress management resourcesFamily support: parental leave, adoption assistance and family benefitsOther benefits: optional legal and pet insurance, transportation savings and moreHow You'll Make An Impact In This RoleAdvocate for appropriate care by reviewing admissions and service requests to ensure every patient receives the right level of medical necessity at the right time.Guide complex patient journeys through expert case management and consultation, providing a roadmap for high-quality outcomes in even the most challenging clinical situations.Support the frontline care team by resolving documentation and reimbursement hurdles, ensuring the hospital can focus its resources on direct patient care.Coordinate seamless transitions by collaborating with the healthcare team to build safe, effective discharge plans that set patients up for success long after they leave our facility.Maintain clinical integrity by overseeing compliance with federal and payer regulations, protecting our patients and our organization from administrative risk.What Minimum Requirements You'll NeedLicensure / Certification / Registration: Registered Nurse credentialed from the Maryland Board of Nursing obtained prior to hire date or job transfer date required.Education: Diploma from an accredited school/college of nursing OR Required professional licensure at time of hire.What Additional Preferences We're SeekingSpecialized Expertise: Proven experience in Utilization Management, Case Management, or Clinical Documentation Improvement within a healthcare setting.Equal employment opportunity employerAscension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.Fraud prevention noticeProspective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system.E-Verify statementEmployer does not participate in E-Verify and therefore cannot employ STEM OPT candidates.
$68.28k - $110.27k
...Utilization Review Nurse Under general supervision, provides consultative support to the admitting teams concerning patient status determinations... ...Licensure, Certifications: Current state of Maryland Registered Nurse license Bachelor of Science in Nursing (BSN)...SuggestedLocal areaWeekend work- ...Boston Medical Center is seeking an experienced utilization management RN to support admitting teams in determining patient status and optimizing hospital resources. You will review clinical information using InterQual/MCG guidelines to ensure medical necessity, length...Suggested
$40.12 - $62.19 per hour
...Utilization Review Nurse RN The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial... ...to review cases not met with criteria Requirements: Registered Nurse License - Current Maryland license or eligibility to...Suggested- Role Overview The Utilization Review Nurse RN conducts initial, concurrent, and retrospective reviews of medical records to evaluate clinical... ...documentation of actions taken. Qualifications & Skills Current registered nurse license (Maryland license or eligibility) Associate’...SuggestedPart timeShift workWeekend work
- ...Clinical Medical Review NurseAmpcus Inc. is a certified global provider of a broad range... ...and population health data to support utilization review, ad?hoc requests, and client... ...rationale (inquisitive).Qualifications:Registered Nurse (RN) – active state or compact license....SuggestedRemote work
- ...Utilization Management Nurse Specialist Lumen Solutions Group Inc. is a technology consulting Services company based in Florida. We provide a... ...Utilization Management Nurse Specialist to support utilization review and care management activities within a managed care...Contract workWork at officeRemote work
$36.49 - $41.49 per hour
...regulatory requirements.Participate in medical policy meetings, nursing forums, and review sessions with medical and dental leadership.Contribute to... ....Experience in case management, discharge planning, or utilization review.Strong understanding of clinical practices and...Work at office- ...Job Title: Clinical Medical Review Nurse. Location: Baltimore, MD. Job Description... ...the descriptive or medical information utilizing the CPT and HCPCS manuals. Keeps up to... ...Licenses/Certifications: ~ RN - Registered Nurse - State Licensure And/or Compact...Work at officeImmediate start
$37.75 per hour
...Nurse Graduate Under direct supervision of a registered nurse, participates in the nursing process by delivering care to... ...the assigned unit. The nurse will utilize this time to learn the... ...applicable): Shift Differential Review the 2025-2026 UMMS Benefits Guide...Full timeShift work$68 per hour
...Job Title: Utilization Management Specialist (RN) Location: Baltimore, MD Type: Contract... ..., concurrent, and retrospective reviews for authorization, appropriateness of care... ...Requirements ~5+ years of Clinical Nursing experience ~2+ years of Utilization Management...Contract workTemporary workLocal areaRemote work- ...Clinical Resource for others, utilizes and integrates evidence into... ...practice on the unit, and to the nurse manager for the totality of... ...; leads unit based peer review processes. 2. Actively engaged... ...Experience: Licensure as a Registered Nurse in the state of...Work experience placement
- ...Nurse Role This role is considered the minimum role for all... ...clinical resource for others, utilizes and integrates evidence into... ...development of unit based peer review processes; actively participates... ...: Licensure as a Registered Nurse in the state of Maryland...Work experience placementShift workNight shift
- ...evaluate hospital core orientation, nursing orientation, in-service... ...Assumes the lead role in review and revision of nursing core... ...policies and implements changes utilizing appropriate channels. Synthesizes... ...Experience Licensure as a registered nurse or related health care...Temporary workPart timeWork experience placement
$240k
...Certified Registered Nurse Anesthetist The Certified Registered Nurse Anesthetist will work... ...the Hospital, including pre-operative review of patients and provision of anesthetics... ...solve them Appropriately plans and utilizes required resources for various job duties...Part timeLocal areaFlexible hoursShift workWeekend work$80k - $95k
...Medical Review Nurse III Fully Remote Windsor Mill, MD Overview Salary Range $80,... ...National and Local Coverage Determinations, utilization/practice guidelines, and clinical... ...Required Education and Experience Registered Nurse, with a current unobstructed license...Full timeContract workFor contractorsLive inWork at officeLocal areaRemote work$37.15 - $57.58 per hour
...Center Rapid Evaluation Unit (REU) Observation Center Registered Nurse Highlights and Career Growth: · Grow your skills through... ...an advisor and resource for patients and their families. · Utilize clinical reasoning which includes clinical decision making, utilization...Full time$39.35 - $54.05 per hour
*Job Requirements * Registered Nurse (RN), Stroke, Day Shift 7a-7p Principal Responsibilities... ...as Clinical Resource for others, utilizes and integrates evidence into practice,... ...and development; leads unit based peer review processes. 3. Actively engaged in advancing...Work experience placementDay shift- ...role is considered the minimum role for all nurses at BWMC who have greater than ( ) 12... ...in roles specific to the unit 3. Utilizes and integrates evidence into practice... ....) 6. Provides feedback for peer review as requested Practice Focus Areas...Full timeTemporary workWork experience placementTrial periodShift workNight shiftRotating shift
- ...Clinical Medical Review NurseWe are seeking Licensed Practical Nurses (LPN) or Registered Nurses (RN) to join the Quality team as Clinical Medical Review Nurses. This is a hybrid contract position requiring both remote work and regular onsite presence at the Canton, MD...Contract workWork at officeRemote work2 days per week3 days per week
- ...Trusted is seeking an experienced nurse for this exciting travel nursing assignment.... ...0 days every 6 weeks. Frequency will be reviewed during interview. - 30-minute response time... ...Life Support) • CCRN (Critical Care Registered Nurse) Skills Checklist: Yes...Contract workLocal areaShift workWeekend workWeekday work
$39.35 - $54.05 per hour
...Night Shift Nursing Position The estimated start date targeted... ...months experience. The nurse will utilize this time to learn the... ...6. Provides feedback in peer review as requested. Work Experience... ...Qualifications: 1. Licensure as a Registered Nurse in the state of...Work experience placementRelocation packageFlexible hoursNight shift$42.65 - $50.75 per hour
...Surgery Center is hiring a Part Time Pre Op/PACU RNPre Op/PACU Registered Nurse (PACU RN) at Timonium Surgery Center The PACU Registered... ...procedure rooms with various tasks, conscious sedation, and utilizing sterile techniques as deemed appropriate. Will provide total...Temporary workPart time- ...PRN Pacu NurseOpening for an experienced PRN PACU Nurse in a free standing ambulatory surgical center. Center is a multi specialty center... ...to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor....ReliefWeekend work
$37 - $51.81 per hour
...Registered Nurse, (RN), PACU, PRN, Unit Base Tier II University of Maryland St. Joseph Medical Center offers a beautiful 37‑acre, 218‑bed... ...Compensation Pay Range: $37 – $51.81 Other Compensation (if applicable): None. Review the 2025‑2026 UMMS Benefits Guide. #J-18808-Ljbffr...Relief$32.18 - $49.46 per hour
...Education Associate Degree from an accredited School of Nursing required. Experience Two years Registered Nurse experience required in the specific specialty... ...recovery. Principal Duties and Responsibilities Utilization of Nursing Process Assessment Compiles database and...Local area- ...Greater Baltimore Medical Center (GBMC) seeks a dedicated Registered Nurse who will be essential in the assessment, planning, implementation... ...with two years of relevant experience. The role involves utilizing the nursing process and ensuring excellence in care, emphasizing...
- ...System seeks RN clinicians for the Neonatal Escalation Safety Telemetry (NEST) program. The remote monitoring team operates 24/7 to review fetal tracings, escalating concerns to bedside teams. On-site work is required, with responsibilities spanning clinical care,...Remote work
$24.2 - $53.21 per hour
...Under moderate supervision, supports physicians in reviewing clinical documentation to manage each patient's care... ...: Essential: * Bachelor of Science in Nursing Credentials: Essential: * Registered Nurse License Experience: Essential: * 5-...Full time$39.35 - $54.05 per hour
...Outpatient Infusion Nurse – Stoler Pavilion (UMMC)This position is based at the Stoler... ...mandatory classes/training.Licensure as a Registered Nurse in the state of Maryland, or eligible... ...54.05Other Compensation (if applicable): Review the 2025-2026 UMMS Benefits GuideLike...Full timeTrial period10 hours per weekShift work- ...including psychotropic medicines. Psychiatric nurses provide a range of therapies to clients... .... Understand Electronic Health Record, utilize to its fullest capabilities, and have... .... Identifying complex problems and reviewing related information to develop and evaluate...Work at officeLocal area
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