Utilization Management Specialist II

Renowned as the academic flagship of the University of Maryland Medical System, our Magnet®-designated facility is a nationally recognized, academic medical center with opportunities across the continuum of care.  Come join UMMC and discover the atmosphere where talents and ideas come together to enhance patient care and advance the science of nursing.  Located in downtown Baltimore near the Inner Harbor and Camden Yards, you won’t find a more vibrant place to work! 

Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient’s need for outpatient or inpatient care as well as the appropriate level of care. The role requires interfacing with the case managers, medical team, other hospital staff, physician advisors and payers.

Education and Experience

• Licensure as a Registered Nurse or other equivalent health care license in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required
• Minimum of 12 months experience in case management or utilization management required

All your information will be kept confidential according to EEO guidelines.