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We’re making Maryland stronger!
With roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a pioneer in orthopedics and neurological disorders. From bones to brains, our cutting-edge hospital heals even the most serious of injuries, specializing in everything from total joint replacement to spinal cord injuries and neurological condition. In total, our 141-bed facility welcomes over 3,000 patients every year. As the state’s largest provider of inpatient rehabilitation services, we offer some of the most advanced therapies for stroke, spinal cord injury, traumatic brain injury, orthopedic and sports injury, among many others.
Job Description
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.
Qualifications
Bachelors in Nursing required. Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required.
Ability to work with Hospital/Utilization Management and related software programs is required.
2 years of experience in case management or utilization management with knowledge of payer mechanisms and utilization management is preferred. Familiarity with acute rehab preferred. Certified Professional Utilization Reviewer (CPUR) preferred.
Additional Information
All your information will be kept confidential according to EEO guidelines.
