Utilization Mgmt RN Job Listing at MedStar Medical Group in MD (Job ID req43525)

Description

General Summary of Position
Responsible for evaluating the necessity, appropriateness and efficiency of the use of medical services, procedures and facilities. Responsible for clinical review of acute care services based on Medically Necessity criteria, the management of quality health care resources for achievement of desired outcomes, and coordination of alternative levels of care in a timely and in the most cost-effective manner. We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels.

Primary Duties and Responsibilities

Minimum Qualifications
Education

• Valid RN license in the District of Columbia; or Maryland required and
• Bachelor's degree preferred

Experience

• 1-2 years Recent utilization experience required and
• 1-2 years Diverse clinical experience required

Licenses and Certifications

• RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the District of Columbia; or Maryland Upon Hire required and
• CCM - Certified Case Manager CCM (Certified Case Manager) Upon Hire preferred

Knowledge, Skills, and Abilities

• Proficient computer skills to enter and retrieve data.
• Ability to create, edit and analyze Microsoft office (Word, Excel, and PowerPoint) preferred.
• Knowledge of InterQual guidelines preferred.

This position has a hiring range of $87,318 - $157,289