Utilization Review Nurse (RN) Manager – Health insurance – Paid time off – Pto -Hanover, MD Position Available In Grafton, New Hampshire
Tallo's Job Summary: The Utilization Review Nurse (RN) Manager position in Hanover, MD, at a health insurance company offers a competitive salary ranging from $80,059.20 to $132,100.80. Responsibilities include managing utilization review processes, collaborating with leadership, and overseeing department operations. Requirements include RN licensure, 3 years of experience, and 1 year of leadership experience. The employer, Ascension St. Agnes Hospital, provides various benefits, including paid time off, health insurance options, retirement benefits, and more.
Job Description
Job Description:
Details Department:
Utilization Management Schedule:
On-site, Monday-Friday, 8:00AM-4:30PM.
Hospital:
Ascension St.
Agnes Hospital Location:
Baltimore, MD Salary:
$80,059.20 – $132,100.80 Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community Benefit options and eligibilityvary by position. Compensation varies based on factors including,but not limited to, experience, skills, education, performance andsalary range at the time of the offer. Responsibilities Manage effective utilization review processes,including management of patient statusing processes and monitoringof medical necessity review functions for assigned sites. Collaborate with the director to develop and implement qualityreview programs and key performance indicators for all utilizationreview activities. Interact with medical, nursing, and executive leadership tofacilitate quality based, cost effective patient statusing in themost appropriate setting, in compliance with regulatory and revenuecycle requirements. Oversee day-to-day operations of the department and assistswith the budgeting process. Serve as content specialist for staff in the areas ofutilization criteria, appeal and review process, and casemanagement system documentation. Conduct hiring, training, directing, development and evaluationof staff Requirements Licensure / Certification /
Registration:
Registered Nurse obtained prior to hire date or job transferdate required.
Education:
Required professional licensure/certification AND 3 years ofexperience and 1 year of cumulative leadership experiencerequired.
Work Experience:
Two years of related experience is required. Additional Preferences Must be available as needed to address urgent or time-sensitiveissues outside of regular business hours. This includes providingsupport for on-call situations, troubleshooting problems, andensuring effective resolution to maintain smoothoperations.
Registered Nurse, Certified Case Manager (CCM, ACM,URAC) preferred or willing to obtain within 1 year. Why Join Our Team Ascension Saint Agnes in Baltimore, Marylandoperates a full-service, 254-bed teaching hospital, the AscensionSaint Agnes Medical Group, Ascension Saint Agnes Imaging Center andAscension Saint Agnes Foundation. As an associate, you will be apart of a team that is committed to providing a place of respectand inclusion for all associates, as well as a rich learningenvironment with countless opportunities for career growth andprofessional development. Ascension is a leading non-profit,faith-based national health system made up of over 134,000associates and 2,600 sites of care, including more than 140hospitals and 40 senior living communities in 19 states. OurMission, Vision and Values encompass everything we do at Ascension.
Every associate is empowered to give back, volunteer and make apositive impact in their community. Ascension careers are more thanjobs; they are opportunities to enhance your life and the lives ofthe people around you. Equal Employment Opportunity Employer Ascension will provide equalemployment opportunities (EEO) to all associates and applicants foremployment regardless of race, color, religion, national origin,citizenship, gender, sexual orientation, gender identification orexpression, age, disability, marital status, amnesty, geneticinformation, carrier status or any other legally protected statusor status as a covered veteran in accordance with applicablefederal, state and local laws. For further information, view theEEO Know Your Rights (English) poster or EEO Know Your Rights(Spanish) poster. As a military friendly organization, Ascensionpromotes career flexibility and offers many benefits to helpsupport the well-being of our military families, spouses, veteransand reservists. Our associates are empowered to apply theirmilitary experience and unique perspective to their civilian careerwith Ascension. Pay Non-Discrimination Notice Please note thatAscension will make an offer of employment only to individuals whohave applied for a position using our official application. Be onalert for possible fraudulent offers of employment. Ascension willnot solicit money or banking information from applicants. ThisMinistry does not participate in E-Verify and therefore cannotemploy
STEM OPT
candidates.
