Registered Nurse (RN) – Utilization Review

Facility

Johns Hopkins Healthcare


Location

Glen Burnie, MD


Contract Terms

Registered Nurse (RN) – Utilization Review
Johns Hopkins Home Care

Currently seeking a RN for a 13 week assignment (with possible extension) in Baltimore, MD.

Monday-Friday 8-4:30pm

Description of Duties: The RN will review medical records from multiple facilities, providers for quality of care reviews. This position may also include writing formal reports and presenting information at committee meetings, May also audit files of other nurses.

Knowledge: Must exhibit knowledge of medical records and analysis of processes of clinical care in addition to exhibiting familiarity with quality principles and standards such as accreditation, HEDIS, Medicare STARS, or quality of care (QoC)

Skills: Prior experience with PC application including word processing, graphics and spread sheet experience preferred. Work requires the ability to work both independently and as a member of the JHHC team. Must assist the organization with maintaining compliance. Must possess planning and organizational skills. Must demonstrate ability to accept and institute change. Must have strong analytical skills and statistical aptitude. Work requires excellent verbal, written, and listening communication skills and the ability to be detail-oriented and well organized. Work requires excellent interpersonal skill and the ability to maintain a credible and professional image with staff, member, physicians and business-related individuals.

Work Experience: Work requires a minimum of two years’ experience in managed care, a provider setting, or health care regulatory agency environment with a minimum of two years of experience in the area of HEDIS, utilization management, or quality improvement.

 

OR

Skills: Excellent verbal and written communication skills to effectively interact and work correctively with enrollees Physicians facility staff and management staff in English. Work requires excellent interpersonal skills and attitude to effectively projected positive image of Managed Care Program. Computer skills working with a variety of applications and online systems. Knowledge of Enterprise and utilizing various criteria sets for example and InterQual. Ability to negotiate and resolve conflicts with external customers.

Work Experience: Minimum of 5 years of Acute Care Nursing experience. Participation in quality improvement activities. Managed care experience in utilization review for at least one year required

 

Full-time Starting ASAP
13 weeks with possible extension.
For immediate consideration, please send your resume via email to MDjobs@cms24-7.com

IS34814

IS34917


Shift Time

Days


Weekend/Holiday

Every other weekend/holiday


Float

Float As Needed


Pay Rate

$45 / Hour


Skill Set Requirements

Must have at least 2 years of clinical experience and 2 years in the specialty requested.
Registered Nurse (RN) – Utilization Review


Profile Requirements

Require an updated resume, skills checklist, and two recent manager or supervisory references. Please note these are the standard requirements but they can vary by facility. Need active MD or compact license.


Rate Details

Please note: Quoted pay rate is for local candidates. Travelers will be paid the equivalent of the local rate minus housing. Housing stipends available. Please note orientation is paid at full rate and parking is reimbursed. Travelers please request a sample pay stub to know to see your take home wage.