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Utilization review nurse jobs in Arlington, VA - 169 jobs

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  • Travel Transplant Nurse Coordinator

    Access Healthcare 4.5company rating

    Utilization review nurse job in Washington, DC

    Access Healthcare is seeking a travel nurse RN Transplant for a travel nursing job in Washington, District of Columbia. Job Description & Requirements Specialty: Transplant Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel Access Healthcare Job ID #75080561. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. About Access Healthcare Access Healthcare aims to provide superior service to our nursing family by providing around the clock support, competitive pay packages and an unmatched benefits package! Unlike other agencies, we offer a true family feel and work with you to find the placement that is right for you. We offer one of the top leading pay packages in the industry and we are ready to get you the money you deserve! Access Healthcare was founded by two travel nurses, Danielle and Diego, who had a dream and a shared vision of creating an agency which all nurses would want to work with. Our passion has led us to where we are today as one of the top 10 agencies in our home state of New Jersey, with access to contracts in all 50 states! We encourage you to join our team and we cannot wait to get to know you!
    $72k-89k yearly est. 1d ago
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  • Neurosurgery NP/PA

    Inova Health System 4.5company rating

    Utilization review nurse job in Fairfax, VA

    InovaNeurosurgeryis looking for a dedicated Acute Care Nurse Practitioner or Acute Care Physician Assistant (NP/PA) to join the team at Inova Fairfax Medical Campus.This position is eligible for sign-on bonus and relocationassistance. Inova Neurosurgery is one of the countries most advanced neurosurgical practices specializing in brain, endovascular, spine,brain and spine cancer, while working together to provide compassionate integrated care. Inova is consistentlyranked a national healthcare leader in safety,quality and patient experience.We are also proud to be consistentlyrecognizedas a top employer inboththe D.C. metro area and the nation. Committed to Team Member Health:offering medical, dental and vision coverage, and a robust team member wellness program. Retirement:Inova matches the first 5% of eligible contributions - starting on your first day. Tuition and Student Loan Assistance:offeringup to $5,250 per yearin educationassistance and up to $10,000 for student loans. Mental Health Support:offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost. Work/Life Balance:offeringpaid time off, paid parental leave, flexible work schedules. Neurosurgery Advanced Practice Provider Job Responsibilities: APP willbe responsible for all aspects of the service to include daily rounds and progress notes. Emergency Room and inpatient consults, admissions, and discharges Ordering and interpreting labs and radiologic studies Fielding phone calls from inpatient nurses. Multidisciplinary care coordination and patient education. You may also perform procedures - within the scope of practice of Inova Health credentialing and privileging - to include EVD and ICP monitor placement. Some opportunity exists forfirst-assisting in the OR, as service needs permit or require. The APP will work directly with the neurosurgeons. Additional Requirements: Work schedule:Full-time - 3/12 hour shifts per week Education:Mastersin Advanced Clinical Practice or graduate of a post masters certificate program for nurse practitioners, OR certificate from an education program that is accredited by the Council of Nurse Anesthesia Educational Programs/Schools, American College of Nurse Midwives, American Association of Colleges of Nursing of the National League for Nursing. For physician Assistants, graduate of an accredited Physician Assistant program and certification by National Commission on Certification of Physician Assistants. Experience:No experience required. Certification:Basic Life Support (BLS) upon start Licensure:Licensed Physician Assistant or Nurse Practitioner; If Nurse Practitioner: RN Compact License(depending on State of primary residence) AND a license (or eligibility for) as a nurse practitioner or physician assistant in the Commonwealth of Virginia AND a "Practice Agreement" signed by sponsoring/ supervising physician(s), AND a written "Scope of Practice/Protocol" signed by the supervising physician, AND "Drug Enforcement Administration License" (if prescribing controlled substances) Payer Credentialing:Ability to successfully complete the credentialing process by third-party payors and Ability to enrolled as a CMS Medicare/Medicaid payor Medical Staff Credentialing:Successful completion of credentialing for Medical Staff membership and appropriate clinical privileges sufficient to perform all required services Preferred Qualifications: Minimum of one year of experience in inpatient neurosurgery,. Recognizing that research and innovation are vital elements to providing world-class patient care, Inova participates in a large number of cutting-edge clinical trials and research projects. Our diverse clinical activities make us a first-class locationn Our commitment to ensure high-quality care is strengthened by our range of rigorous professional education programs to improve medical practice skills and patient outcomes. Inova's work extends beyond the walls of our hospitals and outpatient centers. We bring disease-prevention programs, health and exercise classes, for vulnerable children and adults directly to the community through our many outreach programs and partnerships. At Inova, more than 18,000 employees demonstrate their commitment every day to providing the community with expert, world-class, compassionate patient care. About Us We are Inova, Northern Virginia's leading nonprofit healthcare provider. Every day, our 26,000+ team members provide world-class healthcare to the communities we serve. Our people are the reason we're a national leader in healthcare safety, quality and patient experience. And from best-in-class facilities to professional development opportunities, we support them at every step. At Inova, we're constantly striving to be ever better - to shape a more compassionate future for healthcare. Inova Health System is an Equal Opportunity employer. All qualified applicants will receiveconsideration for employment without regard to age, color, disability, gender identity orexpression, marital status, national or ethnic origin, political affiliation, pregnancy (includingchildbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation,veteran status, genetic information, or any other characteristics protected by law. #J-18808-Ljbffr
    $59k-84k yearly est. 4d ago
  • Utilization Management Nurse

    Centerwell

    Utilization review nurse job in Annapolis, MD

    **Become a part of our caring community and help us put health first** Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we're seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others. **Preferred Locations:** Daytona, FL, Louisville, KY, San Antonio, TX **Use your skills to make an impact** **Role Essentials** + Active Unrestricted RN license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work independently and within a team setting + Valid driver's license and/or dependable transportation necessary + Travel for offsite Orientation 2 to 8 weeks + Travel to offsite meetings up to 6 times a year as requested + Willing to work in multiple time zones + Strong written and verbal communication skills + Attention to detail, strong computer skills including Microsoft office products + Ability to work in fast paced environment + Ability to form positive working relationships with all internal and external customers + Available for On Call weekend/holiday rotation if needed **Role Desirables** + Education: BSN or bachelor's degree in a related field + Experience with Florida Medicaid + Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid Experience a plus + Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual **Additional Information** We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more. To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-18-2026 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
    $71.1k-97.8k yearly 12d ago
  • Formulary Strategy & Utilization Review Pharmacist

    Pharmacy Careers 4.3company rating

    Utilization review nurse job in Washington, DC

    Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape-analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective DUR and prepare stakeholder reports. Qualifications: PharmD with managed care, DUR, or pharmacy benefit experience. Strong Excel/data analytics background preferred. Understanding of clinical guidelines and P&T processes. Why Join Us? Join a top-tier managed care team Hybrid flexibility Strategic and data-driven focus
    $72k-86k yearly est. 60d+ ago
  • Utilization Review Nurse PRN

    Johns Hopkins Medicine 4.5company rating

    Utilization review nurse job in Columbia, MD

    Make it happen at Hopkins As a member of Johns Hopkins Medicine, Johns Hopkins Howard County Medical Center is a 266-bed acute care facility that has been serving the community for nearly 40 years. We can offer the most advanced, innovative technology with the collaboration and teamwork typically found in a community hospital. What you will do: The Utilization Review (UR) Nurse performs UR and Payor management activities, which include prospective and/or retrospective chart and clinical systems review to measure UR issues that affect reimbursement for the patient's hospital stay or visit. Responsibilities include medical record review, communication with third party payors, third party payor initial denials, and special projects which are coordinated and directed by the UR Payor Management Team Leader. May design and initiate special projects as supervised by Manager, Utilization Management. Why nurses love Howard County Medical Center: Warm and collegial environment Fantastic benefits: hcgh.mybenefitsjhhs.com Free parking and more What you will need: Graduate of an accredited school of nursing. BSN is required. Minimum of three (3) years of relevant clinical experience required, of which demonstrated abilities in the areas of discharge planning, utilization, and quality management is highly preferred . Experience in two or more clinical areas are preferred. Salary Range: Minimum 53.47/hour - Maximum 53.47/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices. Johns Hopkins Health System and its affiliates are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law. Johns Hopkins Health System and its affiliates are drug-free workplace employers.
    $58k-71k yearly est. 1d ago
  • Utility Coordinator

    Whitman, Requardt and Associates, LLP 4.5company rating

    Utilization review nurse job in Fairfax, VA

    At Whitman, Requardt & Associates, LLP, we are "People Focused and Project Driven". We have been in business for 110 years and we are known for our quality work and quality employees. This is your chance to join our team - help us to design the infrastructure and buildings that improve the world! We are currently seeking a Utility Coordinator reporting to our office in Fairfax, VA. The position will involve coordinating the identification, protection, design and relocation of public and private utilities to accommodate the design and construction of infrastructure projects. The successful candidate must have excellent technical, organizational, and communication skills to effectively interface with utility owner personnel and project design and construction personnel. A thorough knowledge of local, State, and Federal requirements related to utility work and understanding of transportation/infrastructure design and construction projects is essential for job execution. Responsibilities: Project assignments will include researching and obtaining utility record drawings and facilitating Subsurface Utility Engineering (SUE) activities to identify and locate utilities. The candidate will be responsible for interfacing with utility owner personnel and project design and construction personnel to establish roles and responsibilities for utility design and construction activities and track these activities though the project life. The candidate also will be responsible for performing and/or coordinating design and constructability reviews related to as-built, and/or proposed utilities for projects. Requirements: * Bachelor of Science degree in Civil Engineering or other relevant discipline from an ABET accredited program * Minimum of 5-10 years of experience with utility coordination/design or related work * Licensed as a PE (preferred) * Experience with utility design, coordination and utility construction methods * Experience working with MicroStation/GEOPAK/OpenRoads Designer and/or AutoCAD * Exceptional communication, technical writing, presentation, and organizational skills * Mentors, manages, and provides oversight of the Utility Coordination Team in all aspects of utility coordination * Experience with Microsoft Office (Word, Excel, Outlook) * Positive attitude and willingness to work cooperatively with others * Experience with managing complex utility projects * Ability to handle multiple assignments * Assist business development UC and utility design including client management, and overall proposal development with technical approach understanding and proposal development * Develops scopes, and Fee estimates for project assignments * Prepare and monitor project budgets, successfully manage and deliver projects on time and on budget, while meeting quality requirements * Performs utility records, prior rights and existing utility agreements research and statistical analysis * Construction utility coordination including monitoring utility adjustments/relocation schedules, review of utility relocation reimbursement invoices, private utility coordination/facilitation to assure relocations remain on or ahead of schedule during construction, and resolution assistance of utility conflicts encountered during construction * Facilitates the execution of various utility agreements between utility owners and state DOT's Benefits: WRA recognizes that employees play an important role in its success. Our commitment to full-time employees is reflected in the comprehensive benefits package we offer: * Flexible work schedule options * Competitive salary * Leave accrual and paid holidays * Healthcare benefits * Group Life Insurance, as well as additional optional life Insurance, short and long term disability insurance * Flexible spending accounts for medical and dependent care reimbursement * 401(k) Retirement Plan * Tuition Reimbursement * Employee Assistance Program * Parental and maternity leave benefits WRA is an equal opportunity/affirmative action employer and complies with all applicable anti-discrimination laws. Applicants must be currently authorized to work in the United States on a full-time basis without the need for employment-based visa sponsorship now or in the future. WRA will not sponsor applicants for U.S. work visa status for this opportunity. (no sponsorship is available for H-1B, L-1, TN, O-1, E-3, H-1B1, F-1, J-1, OPT, CPT or any other employment-based visa) * Not accepting resumes from 3rd party recruiters for this position * Position # 2888 #LI - Onsite #LI - Mid-Level
    $50k-64k yearly est. 41d ago
  • Utilization Management CoordinatorNE

    University of Maryland Medical System 4.3company rating

    Utilization review nurse job in Glen Burnie, MD

    Experience the highest level of appreciation at UM Baltimore Washington Medical Center - named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Workplace in the USA for 2021! As part of the acclaimed University of Maryland Medical System, our facility is one of three ANCC Pathway to Excellence designated hospitals in Maryland. UM BWMC features one of the state's busiest emergency departments, as well as a team of experts who care for our community and one another. The University of Maryland Baltimore Washington Medical Center (UMBWMC) provides the highest quality health care services to the communities we serve. Our medical center is home to leading-edge technology, nationally recognized quality, personalized service and outstanding people. We have 285 licensed beds and we're home to 3,200 employees and over 800 physicians. Our expert physicians and experienced, compassionate staff are connected to medical practices in the local community as well as at University of Maryland Medical Center in downtown Baltimore. For patients, this means access to high-quality care and research discoveries aimed at improving Maryland's health. Our physicians and nursing staff specialize in emergency, acute, medical-surgical and critical care. In addition, our medical center is home to many Centers of Excellence, offering expert outpatient health care. Job Description General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory agencies to assure compliance with regulatory and reimbursement requirements.The position is goal-oriented with a high level of accountability correlated to maximizing reimbursement and minimizing denials. Mission All employees are responsible for extending the mission and values of Baltimore Washington Medical Center by dedicating oneself to providing the highest quality healthcare services to the communities we serve. Reporting Relationships Reports to the Director of Care Management. Qualifications Education:Graduation from an accredited nursing education program approved by the Board of Nursing or found to be substantially equivalent to the programs in Maryland. Currently licensed as a Registered Nurse in the State of Marylandrequired, BSN preferred. Experience:Three (3) yearsof relevantclinical experience required.Ongoing education, certification, and self development to remain current with industry standards and business objectives related to hospital utilization and case management. Additional Information All your information will be kept confidential according to EEO guidelines. Compensation: Pay Range: $40.61 - $60.96 Other Compensation (if applicable): Review the 2025-2026 UMMS Benefits Guide Like many employers, UMMS is being targeted by cybercriminals impersonating our recruiters and offering fake job opportunities. We will never ask for banking details, personal identification, or payment via email or text. If you suspect fraud, please contact us at [email protected].
    $40.6-61 hourly 39d ago
  • Clinical Nurse - Case Manager

    Saratoga Medical Center 4.3company rating

    Utilization review nurse job in Falls Church, VA

    Saratoga Medical is hiring for a Clinical Nurse, Case Management in Falls Church, Virginia. Package includes competitive rate, paid time off and benefit options. This is a great full-time opportunity with telework available. Please see the qualifications below and submit your resume if you are interested in being considered. Required Qualifications: Bachelor's degree in Nursing, Master's preferred, or other clinically related Health Service degree. Department of Defense Program Management (PM) experience preferred, minimum 2 years within the last 5 years. Experience in the operations and organization of the Department of Defense Military Health System desired. Saratoga Medical Center, Inc. is an equal opportunity employer and will not discriminate in recruiting, hiring, training, promotion, transfer, discharge, compensation or any other term or condition of employment on the basis of race, religion, color, age (over age 39), sex, national origin, or on the basis of disability if the employee can perform the essential functions of the job, with a reasonable accommodation if necessary.
    $64k-82k yearly est. Auto-Apply 60d+ ago
  • Nursing Coordinator

    Neighborhood Health 4.3company rating

    Utilization review nurse job in Alexandria, VA

    PRIMARY FUNCTIONS: The Nursing Coordinator works with the Nursing Manager and Chief Medical Officer to facilitate access to high quality, safe, patient-centered medical care for all Neighborhood Health patients regardless of race, age, or ability to pay. The Nurse Coordinator is responsible for the supervision of the site's clinical support staff and performs clinical duties when needed including triage and high-risk case management. Demonstrates commitment to Neighborhood Health's mission of improving health and advancing health equity in Alexandria, Arlington, and Fairfax by providing access to high quality primary care regardless of ability to pay. DUTIES/ RESPONSIBILITIES: ( Essential Functions: Duties and responsibilities noted with bullets are considered to be the essential functions of the job) Works with multidisciplinary team, to include the medical provider, behavioral health provider, dental provider, family support worker, referral coordinator, and medical assistant to provide high quality, coordinated, and patient-centered primary care. Supervises, trains, evaluates, and manages schedules of clinical site's medical assistant team and site's care coordinator. With nurse manager, helps plan and coordinate medical assistant training activities. Facilitates daily flow of medical care in clinic. Oversees ordering and maintenance of clinical supplies, onsite medications, and equipment. Works with prior authorization coordinator to obtain insurance authorization for patient medications. Submits prior authorization requests for urgent patient procedures. Oversees patient safety practices at site to conform with ambulatory standards of The Joint Commission. Implements Primary Care Medical Home practices at site. Oversees administration of Virginia state vaccine program. Oversees performance and quality of in-house laboratory tests. Oversees medical provider daily patient schedules, leave requests, and coverage schedules. Performs clinical duties when needed, including phone or in-person triage, nurse visits for chronic care education and management, and communication of clinical information. Manages high risk patient care, including patients with multiple co-morbidities or those at high risk for hospitalization or readmissions. Reports morbidity and reportable conditions to local health department. Along with care coordinators, assists patients in efficiently navigating the health care system. Participates in clinic quality improvement and risk management activities, including data collection, and committee meetings as appointed. Assist with developing, coordinating and recommending changes for the improvement of clinical services in the designated site. Employee will be asked to perform additional duties and take on other responsibilities as dictated by events and circumstances. OTHER DUTIES: Assists with developing, coordinating, and/or recommending improvements in program area. May be assigned to various projects to advance the development or program area. May be asked to assist during weekend or evening. Able to work under minimal supervision. Other duties may be assigned. QUALIFICATION/EDUCATION and/or EXPERIENCE REQUIREMENTS: Registered Nurse licensed in Virginia or compact state. Current Virginia Registered Nurse (RN) license or compact state. Strong interpersonal communication skills. Experience within primary care environment, preferably with Federally Qualified Health Center. Ability to demonstrate commitment to the mission of Neighborhood Health. Ability to work effectively with a diverse work force. Ability to work effectively with diverse and low income patient population. Employee development and performance management skills. Experience with information technology, electronic health records, medical records. Knowledge of local health care environment and capacity to develop partnerships with community partners. Bachelors of Science in Nursing (BSN) preferred. Fluency in Spanish a plus.
    $71k-86k yearly est. Auto-Apply 60d+ ago
  • Radiology Safety Nurse, Tysons

    VHC Health 4.4company rating

    Utilization review nurse job in McLean, VA

    Qualifications Purpose & Scope: Across all levels, the registered professional nurse is responsible for the direct and indirect total nursing care of his / her assigned patients. He / She is also responsible for the supervision of assigned personnel. The position requires knowledge of both department and hospital policies and procedures relevant to the delivery of nursing care. Interpretive skills, frequent interactive and consultative associations, along with management and supervisory skills are inherent in the position. The ability to retrieve, communicate or otherwise present information in a written, auditory or visual fashion is essential. The primary method to express or exchange ideas is through the spoken word. Written, telephone, and manual dexterity skills are required for this position. The Critical Safety Nurse (Radiology) will promote and maintain quality patient care before, during and after radiologic procedures. The Critical Safety Nurse (Radiology) will receive hand-off communication at the time of transport to radiology, monitor and care for the patient during transport to and from radiology, during wait times and while the exam is performed, and provide hand-off communication when the patient is delivered back to the patient's primary place of care within Virginia Hospital Center. The Critical Safety Nurse (Radiology) will promote and maintain quality patient care for outpatients before, during and after radiologic procedures requiring a nurse. These include, but are not limited to, monitoring patients with pacemakers in MRI, providing medications to patients for exams requiring these administrations, and assessing both inpatients and outpatients for contrast reactions and extravasations. The Critical Safety Nurse (Radiology) will communicate with and ensure quality patient care is being provided by having a good working relationship with the radiologists in the Imaging Department. Education: Bachelor's degree in nursing is required. Experience: Five years of healthcare/medical - nursing/patient care experience is preferred. Five years of experience in a critical care setting is preferred. Certification/Licensure: Licensed as a Registered Nurse by the Virginia Department of Health Professions or compact state licensure in nursing is required. BLS certification required. ACLS certification required. CCRN certification or PCCN preferred. CRN certification preferred. Registered Nurses on designated units are required to maintain certain certifications. New to practice area nurses or new graduates have 1 year to complete the specialty requirements below. ACLS: ED, ICU, CVICU, Cardiac Cath Lab, Cardiopulmonary Rehab, Bronch Suite, Interventional Radiology, Radiology Safety Nurses, Step down Units (3A, 3B, 4B), 6A, 6B, 7A, Labor and Delivery, Hemodialysis, Respiratory Therapy, Float pool, GI Unit, and PACU PALS: PACU: Pediatric Nurses, ED NRP: NICU, Mother Baby, Labor and Delivery De-escalation training: BHU, ED Per policy ACLS or PALS cards stand as showing competence in BLS Skills per American Heart Association Guidelines. If an employee holds current ACLS or PALS certification, this meets the requirement for BLS in their job description. They do not need to also carry a separate BLS certification.
    $51k-71k yearly est. 6d ago
  • Nurse

    Epic 4.5company rating

    Utilization review nurse job in Brandywine, MD

    DEPARTMENT: Nursing Services extended weekday hours may be required even in the event of inclement weather; Daily Job Site: Flexible. FLSA STATUS: Exempt CLASSIFICATION: Full Time COMPENSATION: $45.00 FIELD WORK & TRAVEL: Position requires 25% of travel SUMMARY OF POSITION: EPIC is an organization that strives to develop and maintain a harmonious work environment and encourages growth and professional development. All EPIC team members have basic requirements in areas such as Leadership, Team Management, and Compliance Assurance. The position of Registered Nurse is responsible for the administration and implementation of the medical services at EPIC QUALIFICATIONS & REQUIREMENTS: • Must have a Bachelor's Degree. • A graduate of an accredited School of Nursing program with a BSN degree or higher • Must have advanced Microsoft Word skills. • Must possess a local, valid U.S. driver's license with no more than 3 moving violations and/or at fault accidents in the past 3 years or any major violations in the past 5 years • Must have the ability to successfully pass COMAR mandated training and basic skills tests • Must have knowledge of DDA, CMS finale rule and COMAR regulations. • Must have at least 3 years of experience with adults with intellectual disabilities and/or clinical experience and three (3) years of supervisory experience. • Must be certified to train staff on medication administration Soft Skills: • Possess good creative and customer service skills. • Must have good problem solving and critical thinking skills. • Have good adaptability and flexibility to be effective in changing environments. • Possess good conflict resolutions skills. Interpersonal Skills: Page 2 of 4 Registered Nurse DEV 9/2020 EVALUATED COMPONENTS • Ability to closely collaborate across all EPIC programs and departments. • Ability to work together as a team where there is effective communication. • Must possess good communication, analytical, and problem-solving skills. • Must be able to prioritize, multi-task and meet deadlines in compliance with internal and external agencies rules and regulation. • Good time management skills to manage one's own time and the time of others. • Must be responsible and take accountability for own actions **ADDITIONAL REQUIREMENTS WILL BE PROVIDED AT INTERVIEW**
    $45 hourly 60d+ ago
  • Admissions Enrollment for Nursing & Healthcare Professions

    Trinity College 4.0company rating

    Utilization review nurse job in Washington, DC

    Enrollment Admissions Recruiter for The School of Nursing & Healthcare Professionals (NHP) Salary Range 65k to 80k (Annually) - More experienced Enrollment Admissions Recruiters we're flexible with title to include: Assistant Director of Admissions for NHP. Title and salary is based on qualifications and experience. Trinity Washington University seeks an Enrollment Admissions Recruiter for the School of Nursing and Health Professions (NHP) who is sales driven and has knowledge of the healthcare system. This role will build credible relationships among prospective students, families, health care and medical professionals, and community partners, that yield enrollment results. The successful candidate will have healthcare knowledge with previous sales experience, superior interpersonal skills, a commitment to the mission of Trinity, and an understanding of the market. The Enrollment Admissions Recruiter will diligently manage a portfolio of passionate prospects, from inquiry through enrollment working collaboratively with Enrollment Services (Financial Aid, Advising, Student Success, and other offices as needed). The successful candidate will possess a genuine enthusiasm for recruitment work, deploy a creative and personable sales approach, and understand the value of professional collaboration within a student-centered environment. The Enrollment Admissions Recruiter for NHP will recruit and support enrollment goals for new student growth among undergraduate and graduate students. Work closely with a team of highly capable professionals, all committed to the mission of the institution. Desirable candidates will be able to effectively communicate and demonstrate their successful record of relationship management, sales, and stakeholder engagement. Trinity seeks team members with strong communication talents, and an eagerness to develop new relationships as needed to support growth opportunities for the University. This position will report to the Director of Admissions for NHP, and will work collaboratively with Deans and the Associate Vice President of Admissions for Graduate & Professional Schools. About Trinity: Located in the Nation's Capital, Trinity Washington University is a premier, private institution founded in 1897 with 127 years of educational excellence and catholic tradition designed for undergraduate women with graduate, professional, and certificate academic programs for all. Primary Responsibilities: Recruit, steward, and enroll undergraduate and graduate students in the School of Nursing and Health Professions program. Build and manage constituent relationships with healthcare facilities, hospitals, rehabilitation centers, community partners, and community colleges. Develop and execute yield events as needed for the targeted enrollment pipelines. Use data to track enrollment analytics and target efforts for outreach. Produce and provide compelling presentations for multiple constituents to support enrollment growth. Travel to recruitment events (locally and within a nearby radius) to recruit prospective students; actively participate in recruitment events held in person on campus and virtually. Prepare weekly admission reports. Characteristics of successful candidates: Possess knowledge of the healthcare system Strong sales & marketing orientation with demonstrated results Have strong presentation skills Ethical, adhering to high standards of integrity Capable of using data to direct focus/efforts Excellent oral and written communication skills Able to develop a network of relevant relationships Collaborative/Positive team player Highly creative with strong problem-solving skills Commitment to Trinity's mission and strategic goals Bilingual proficiency is highly desired (Spanish) Qualifications: A bachelor's degree is required, Master's degree, is preferred. At least 2 years of successful professional sales-related experience in healthcare is required, College Admissions recruitment experience is preferred. Ability to work a flexible schedule, including evenings and weekends as needed. This position requires driving a personal vehicle on behalf of the university; therefore, the incumbent must possess and maintain a current, valid driver's license. Trinity reimburses mileage and travel expenses. Trinity offers comprehensive and competitive benefits to full-time employees to include Health, Dental & Vision insurance, Employer Paid Life and Disability benefits, 403(b) Retirement plan with employer match up to 6%, Paid Family Leave, Trinity Center Membership Free to all employees to include full size pool, walking track, weight & Cardio equipment, Free campus parking, Free Shuttle bus between campus & Brookland Metro station and more. Trinity Washington University is dedicated to the achievement of excellence and diversity among its students, faculty and staff. Trinity is committed to fostering a diverse and inclusive community and strongly encourages all qualified individuals to apply.
    $62k-77k yearly est. Auto-Apply 19d ago
  • Nursing Graduate - Flex Unit - February 2026 Cohort

    Luminis Health

    Utilization review nurse job in Lanham, MD

    The nursing graduate shall practice only under the direct supervision of a registered nurse who is physically present on the unit to (1) cosign medication transcription, medication administration, and nursing documentation; and (2) continually observe, assist, coordinate, evaluate, and monitor the nursing graduate. The nursing graduate shall use the initials NG after the nursing graduates name as credentials. Transcribe medication orders per written policies and procedures once skill validation has been successfully completed. Administer medications and controlled substances and sign controlled substances sheets Document in the medical record with the abbreviation NG Perform patient assessments after the initial assessment or after the first assessment of the shift performed by the registered nurse. Perform and document routine procedures taught within the nursing graduates generic nursing program including placing nasal gastric tubes, performing urinary catheterizations, applying sterile dressings, performing blood sugar checks and obtaining specimens. Graduate of an accredited registered nursing program. Graduate of an accredited registered nursing program. Eligible to sit for NCLEX - A nursing graduate shall cease practice as a nursing graduate immediately if the nursing graduate fails two attempts at the NCLEX exam or has not successfully taken and passed the NCLEX exam within 120 days of application to the board of nursing. A nursing graduate shall cease practice as a nursing graduate: (a) No later than 120 days after the date the nursing graduate submitted an application to the Board; or (b) Immediately if the nursing graduate fails the second NCLEX examination. A nursing graduate may not: (a) Work without the physical presence of and direct supervision by a registered nurse; (b) Refer to oneself or practice as a registered nurse (RN) or licensed practical nurse (LPN); (c) Be considered a staff person for purposes of a staffing pattern; (d) Accept charge responsibilities; or (e) Perform initial patient assessment or the first patient assessment of a shift, develop patient plans of care, evaluate or document patient discharge, or independently administer medications or intravenous therapy. Luminis Health Benefits Overview: Medical, Dental, and Vision Insurance. Retirement Plan w/employer contribution. Paid Time Off. Employee Tuition Assistance Benefits. Employee Referral Bonus Program Employer Paid Holidays, Disability, and Life/AD&D for full time employees Wellness Programs/Employee Assistance Programs and more Pay Range$25-$30 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance • Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year) • Paid Time Off • Tuition Assistance Benefits • Employee Referral Bonus Program • Paid Holidays, Disability, and Life/AD&D for full-time employees • Wellness Programs • Employee Assistance Programs and more *Benefit offerings based on employment status Opt-in for text notifications! Luminis Health's two-way SMS texting platform lets you receive notifications and messages from our Talent Acquisition team directly on your phone. To enable this feature, select "yes" when asked to "opt-in to receive text messages" and to "Receive updates from a recruiter about this job via SMS" when completing your application. Once you are opted in, you can easily opt-out at any time. Standard text messaging rates may apply based on the candidate's mobile carrier plan. Luminis Health is not responsible for any charges incurred by the recipient. Candidates are encouraged to review their mobile carrier's plan for applicable text messaging rates and usage charges.
    $25-30 hourly 2d ago
  • ECT Nurse (Baltimore/Washington Campus), Part Time

    Sheppard Pratt Careers 4.7company rating

    Utilization review nurse job in Elkridge, MD

    What to expect. We are seeking a dedicated Registered Nurse who is passionate about providing high-quality nursing care to individuals experiencing acute mental health challenges in a supportive and therapeutic inpatient environment. There are available opportunities across multiple units, serving a range of patient populations and diagnoses. We also have flexible shift options including day, evenings, and weekends and do not require psychiatric nursing experience. If you are a registered nurse who is committed to making a positive impact, we encourage you to apply. What you'll get from us. An extended clinical orientation led by Sheppard Pratt's Clinical Education Department to prepare you for the responsibilities of your role. A commitment to professional development, including a comprehensive tuition reimbursement program to support ongoing education and licensure and/or certification preparation Comprehensive medical, dental and vision benefits for benefit eligible positions 403b retirement match Generous paid-time-off for benefit eligible positions Complimentary Employee Assistance Program (EAP) Generous mileage reimbursement program Pay for this position is determined on a number of factors, including but not limited to, years and level of related experience as a registered nurse. What we need from you. Provides care to patients in the ECT suite. Responsible for identified pre-operative, intra-operative, and post-operative nursing care activities involved in carrying out ECT (electroconvulsive therapy), which has been prescribed for the treatment of selected inpatients or outpatients at SP and frequently requires the use of independent judgment. Communicates with patients based on an understanding of the developmental needs of children, adolescents, and/or geriatric population. Works collaboratively with the anesthesiologist and those physicians who have been identified as qualified to administer ECT at this facility. Work requires ability to communicate effectively orally and in writing and a thorough knowledge of psychiatric nursing and physical assessment skills - acquired through two years of college education in nursing. Work requires current license to practice as a Registered Nurse in the State of Maryland at the time of appointment and continually throughout tenure in position. Work requires a level of knowledge of nursing process and physical assessment - acquired through one to two years' inpatient psychiatric nursing, including regular practice of physical assessment skills and demonstrated teaching skills. Work requires a relatively high level of analytical abilities sufficient to identify nursing care problems arising during a prescribed course of ECT, pre-operatively, intra-operatively, and post-operatively. Work requires interpersonal skills sufficient to interact effectively with patients, staff, other departments and disciplines, families, and physicians (51-80% of work time). Works with severely ill psychiatric patients, frequently producing a high level of stress and mental fatigue (51-80% of work time). Work requires talking, hearing, mid-range vision and field of vision. #LI-SH1
    $50k-75k yearly est. 60d+ ago
  • Utilization Management Nurse

    Centerwell

    Utilization review nurse job in Washington, DC

    **Become a part of our caring community and help us put health first** Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we're seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others. **Preferred Locations:** Daytona, FL, Louisville, KY, San Antonio, TX **Use your skills to make an impact** **Role Essentials** + Active Unrestricted RN license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work independently and within a team setting + Valid driver's license and/or dependable transportation necessary + Travel for offsite Orientation 2 to 8 weeks + Travel to offsite meetings up to 6 times a year as requested + Willing to work in multiple time zones + Strong written and verbal communication skills + Attention to detail, strong computer skills including Microsoft office products + Ability to work in fast paced environment + Ability to form positive working relationships with all internal and external customers + Available for On Call weekend/holiday rotation if needed **Role Desirables** + Education: BSN or bachelor's degree in a related field + Experience with Florida Medicaid + Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid Experience a plus + Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual **Additional Information** We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more. To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-18-2026 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
    $71.1k-97.8k yearly 12d ago
  • Utility Coordinator

    Whitman, Requardt & Associates, LLP 4.5company rating

    Utilization review nurse job in Fairfax, VA

    Job Description At Whitman, Requardt & Associates, LLP, we are "People Focused and Project Driven". We have been in business for 110 years and we are known for our quality work and quality employees. This is your chance to join our team - help us to design the infrastructure and buildings that improve the world! We are currently seeking a Utility Coordinator reporting to our office in Fairfax, VA. The position will involve coordinating the identification, protection, design and relocation of public and private utilities to accommodate the design and construction of infrastructure projects. The successful candidate must have excellent technical, organizational, and communication skills to effectively interface with utility owner personnel and project design and construction personnel. A thorough knowledge of local, State, and Federal requirements related to utility work and understanding of transportation/infrastructure design and construction projects is essential for job execution. Responsibilities: Project assignments will include researching and obtaining utility record drawings and facilitating Subsurface Utility Engineering (SUE) activities to identify and locate utilities. The candidate will be responsible for interfacing with utility owner personnel and project design and construction personnel to establish roles and responsibilities for utility design and construction activities and track these activities though the project life. The candidate also will be responsible for performing and/or coordinating design and constructability reviews related to as-built, and/or proposed utilities for projects. Requirements: Bachelor of Science degree in Civil Engineering or other relevant discipline from an ABET accredited program Minimum of 5-10 years of experience with utility coordination/design or related work Licensed as a PE (preferred) Experience with utility design, coordination and utility construction methods Experience working with MicroStation/GEOPAK/OpenRoads Designer and/or AutoCAD Exceptional communication, technical writing, presentation, and organizational skills Mentors, manages, and provides oversight of the Utility Coordination Team in all aspects of utility coordination Experience with Microsoft Office (Word, Excel, Outlook) Positive attitude and willingness to work cooperatively with others Experience with managing complex utility projects Ability to handle multiple assignments Assist business development UC and utility design including client management, and overall proposal development with technical approach understanding and proposal development Develops scopes, and Fee estimates for project assignments Prepare and monitor project budgets, successfully manage and deliver projects on time and on budget, while meeting quality requirements Performs utility records, prior rights and existing utility agreements research and statistical analysis Construction utility coordination including monitoring utility adjustments/relocation schedules, review of utility relocation reimbursement invoices, private utility coordination/facilitation to assure relocations remain on or ahead of schedule during construction, and resolution assistance of utility conflicts encountered during construction Facilitates the execution of various utility agreements between utility owners and state DOT's Benefits: WRA recognizes that employees play an important role in its success. Our commitment to full-time employees is reflected in the comprehensive benefits package we offer: Flexible work schedule options Competitive salary Leave accrual and paid holidays Healthcare benefits Group Life Insurance, as well as additional optional life Insurance, short and long term disability insurance Flexible spending accounts for medical and dependent care reimbursement 401(k) Retirement Plan Tuition Reimbursement Employee Assistance Program Parental and maternity leave benefits WRA is an equal opportunity/affirmative action employer and complies with all applicable anti-discrimination laws. Applicants must be currently authorized to work in the United States on a full-time basis without the need for employment-based visa sponsorship now or in the future. WRA will not sponsor applicants for U.S. work visa status for this opportunity. (no sponsorship is available for H-1B, L-1, TN, O-1, E-3, H-1B1, F-1, J-1, OPT, CPT or any other employment-based visa) ***** Not accepting resumes from 3rd party recruiters for this position ***** Position # 2888 #LI - Onsite #LI - Mid-Level
    $50k-64k yearly est. 12d ago
  • Utilization Review Nurse

    Johns Hopkins Medicine 4.5company rating

    Utilization review nurse job in Severn, MD

    One organization. Countless opportunities. Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States. JHHP is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP has become a leader in provider-sponsored health plans and is poised for future growth. About this position: Work Monday - Friday, the core business hours are 8:00 AM - 5:00 PM As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the opportunity to use your clinical, managed care, utilization review, and verbal/written communication skills to make a difference in our members' lives. Your in-depth knowledge of the appropriate levels of care makes you a valuable resource to our members when they are in need. What you'll do: * Monitor the appropriateness of care received by plan members in a variety of settings * Evaluate member benefits and medical criteria to determine authorization of services * Communicate authorization and/or denial of covered services with all parties involved * Initiate discharge planning of members What awaits you: * Work-life balance - This is a remote role! * Medical, Dental, and Vision Insurance. * 403B Savings Plan w/employer contribution. * Paid Time off & Paid holidays. * Employee and Dependent Tuition assistance benefits. * Health and wellness programs and MORE! What you'll bring: * Understanding of managed care delivery systems and utilization management * Knowledge and expertise in utilizing various criteria sets (i.e. InterQual) * Ability to negotiate and resolve conflicts with external customers. * Unencumbered Registered Nurse (RN) license in Maryland (or Compact state) * 3+ years' experience as an acute care RN * 1+ years' experience in Managed Care/Utilization Review is required Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. Salary Range: Minimum 36.31/hour - Maximum 56.28/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices. Johns Hopkins Health System and its affiliates are drug-free workplace employers.
    $58k-71k yearly est. 5d ago
  • Nursing - OR

    Inova Fairfax Hospital 4.5company rating

    Utilization review nurse job in Falls Church, VA

    Hospital in Virginia is looking for help in their Operating Room. Neuro OR RN's are needed. BLS is required. ACLS, PALS, and or CNOR are preferred. Current VA or compact license is required. Travel experience highly preferred. 2 years experience - Level 1 or 2 trauma experience required. EMR is EPIC. Call Ventura Medstaff today for more information at ************.
    $60k-84k yearly est. 6d ago
  • Admissions Enrollment for Nursing & Healthcare Professions

    Trinity College 4.0company rating

    Utilization review nurse job in Washington, DC

    Enrollment Admissions Recruiter for The School of Nursing & Healthcare Professionals (NHP) Salary Range 65k to 80k (Annually) - More experienced Enrollment Admissions Recruiters we're flexible with title to include: Assistant Director of Admissions for NHP. Title and salary is based on qualifications and experience. Trinity Washington University seeks an Enrollment Admissions Recruiter for the School of Nursing and Health Professions (NHP) who is sales driven and has knowledge of the healthcare system. This role will build credible relationships among prospective students, families, health care and medical professionals, and community partners, that yield enrollment results. The successful candidate will have healthcare knowledge with previous sales experience, superior interpersonal skills, a commitment to the mission of Trinity, and an understanding of the market. The Enrollment Admissions Recruiter will diligently manage a portfolio of passionate prospects, from inquiry through enrollment working collaboratively with Enrollment Services (Financial Aid, Advising, Student Success, and other offices as needed). The successful candidate will possess a genuine enthusiasm for recruitment work, deploy a creative and personable sales approach, and understand the value of professional collaboration within a student-centered environment. The Enrollment Admissions Recruiter for NHP will recruit and support enrollment goals for new student growth among undergraduate and graduate students. Work closely with a team of highly capable professionals, all committed to the mission of the institution. Desirable candidates will be able to effectively communicate and demonstrate their successful record of relationship management, sales, and stakeholder engagement. Trinity seeks team members with strong communication talents, and an eagerness to develop new relationships as needed to support growth opportunities for the University. This position will report to the Director of Admissions for NHP, and will work collaboratively with Deans and the Associate Vice President of Admissions for Graduate & Professional Schools. About Trinity: Located in the Nation's Capital, Trinity Washington University is a premier, private institution founded in 1897 with 127 years of educational excellence and catholic tradition designed for undergraduate women with graduate, professional, and certificate academic programs for all. Primary Responsibilities: Recruit, steward, and enroll undergraduate and graduate students in the School of Nursing and Health Professions program. Build and manage constituent relationships with healthcare facilities, hospitals, rehabilitation centers, community partners, and community colleges. Develop and execute yield events as needed for the targeted enrollment pipelines. Use data to track enrollment analytics and target efforts for outreach. Produce and provide compelling presentations for multiple constituents to support enrollment growth. Travel to recruitment events (locally and within a nearby radius) to recruit prospective students; actively participate in recruitment events held in person on campus and virtually. Prepare weekly admission reports. Characteristics of successful candidates: Possess knowledge of the healthcare system Strong sales & marketing orientation with demonstrated results Have strong presentation skills Ethical, adhering to high standards of integrity Capable of using data to direct focus/efforts Excellent oral and written communication skills Able to develop a network of relevant relationships Collaborative/Positive team player Highly creative with strong problem-solving skills Commitment to Trinity's mission and strategic goals Bilingual proficiency is highly desired (Spanish) Qualifications: A bachelor's degree is required, Master's degree, is preferred. At least 2 years of successful professional sales-related experience in healthcare is required, College Admissions recruitment experience is preferred. Ability to work a flexible schedule, including evenings and weekends as needed. This position requires driving a personal vehicle on behalf of the university; therefore, the incumbent must possess and maintain a current, valid driver's license. Trinity reimburses mileage and travel expenses. Trinity offers comprehensive and competitive benefits to full-time employees to include Health, Dental & Vision insurance, Employer Paid Life and Disability benefits, 403(b) Retirement plan with employer match up to 6%, Paid Family Leave, Trinity Center Membership Free to all employees to include full size pool, walking track, weight & Cardio equipment, Free campus parking, Free Shuttle bus between campus & Brookland Metro station and more. Trinity Washington University is dedicated to the achievement of excellence and diversity among its students, faculty and staff. Trinity is committed to fostering a diverse and inclusive community and strongly encourages all qualified individuals to apply.
    $62k-77k yearly est. Auto-Apply 21d ago
  • Admissions Enrollment for Nursing & Healthcare Professions

    Trinity College 4.0company rating

    Utilization review nurse job in Washington, DC

    Job Description Enrollment Admissions Recruiter for The School of Nursing & Healthcare Professionals (NHP) Salary Range 65k to 80k (Annually) - More experienced Enrollment Admissions Recruiters we're flexible with title to include: Assistant Director of Admissions for NHP. Title and salary is based on qualifications and experience. Trinity Washington University seeks an Enrollment Admissions Recruiter for the School of Nursing and Health Professions (NHP) who is sales driven and has knowledge of the healthcare system. This role will build credible relationships among prospective students, families, health care and medical professionals, and community partners, that yield enrollment results. The successful candidate will have healthcare knowledge with previous sales experience, superior interpersonal skills, a commitment to the mission of Trinity, and an understanding of the market. The Enrollment Admissions Recruiter will diligently manage a portfolio of passionate prospects, from inquiry through enrollment working collaboratively with Enrollment Services (Financial Aid, Advising, Student Success, and other offices as needed). The successful candidate will possess a genuine enthusiasm for recruitment work, deploy a creative and personable sales approach, and understand the value of professional collaboration within a student-centered environment. The Enrollment Admissions Recruiter for NHP will recruit and support enrollment goals for new student growth among undergraduate and graduate students. Work closely with a team of highly capable professionals, all committed to the mission of the institution. Desirable candidates will be able to effectively communicate and demonstrate their successful record of relationship management, sales, and stakeholder engagement. Trinity seeks team members with strong communication talents, and an eagerness to develop new relationships as needed to support growth opportunities for the University. This position will report to the Director of Admissions for NHP, and will work collaboratively with Deans and the Associate Vice President of Admissions for Graduate & Professional Schools. About Trinity: Located in the Nation's Capital, Trinity Washington University is a premier, private institution founded in 1897 with 127 years of educational excellence and catholic tradition designed for undergraduate women with graduate, professional, and certificate academic programs for all. Primary Responsibilities: Recruit, steward, and enroll undergraduate and graduate students in the School of Nursing and Health Professions program. Build and manage constituent relationships with healthcare facilities, hospitals, rehabilitation centers, community partners, and community colleges. Develop and execute yield events as needed for the targeted enrollment pipelines. Use data to track enrollment analytics and target efforts for outreach. Produce and provide compelling presentations for multiple constituents to support enrollment growth. Travel to recruitment events (locally and within a nearby radius) to recruit prospective students; actively participate in recruitment events held in person on campus and virtually. Prepare weekly admission reports. Characteristics of successful candidates: Possess knowledge of the healthcare system Strong sales & marketing orientation with demonstrated results Have strong presentation skills Ethical, adhering to high standards of integrity Capable of using data to direct focus/efforts Excellent oral and written communication skills Able to develop a network of relevant relationships Collaborative/Positive team player Highly creative with strong problem-solving skills Commitment to Trinity's mission and strategic goals Bilingual proficiency is highly desired (Spanish) Qualifications: A bachelor's degree is required, Master's degree, is preferred. At least 2 years of successful professional sales-related experience in healthcare is required, College Admissions recruitment experience is preferred. Ability to work a flexible schedule, including evenings and weekends as needed. This position requires driving a personal vehicle on behalf of the university; therefore, the incumbent must possess and maintain a current, valid driver's license. Trinity reimburses mileage and travel expenses. Trinity offers comprehensive and competitive benefits to full-time employees to include Health, Dental & Vision insurance, Employer Paid Life and Disability benefits, 403(b) Retirement plan with employer match up to 6%, Paid Family Leave, Trinity Center Membership Free to all employees to include full size pool, walking track, weight & Cardio equipment, Free campus parking, Free Shuttle bus between campus & Brookland Metro station and more. Trinity Washington University is dedicated to the achievement of excellence and diversity among its students, faculty and staff. Trinity is committed to fostering a diverse and inclusive community and strongly encourages all qualified individuals to apply.
    $62k-77k yearly est. 21d ago

Learn more about utilization review nurse jobs

How much does a utilization review nurse earn in Arlington, VA?

The average utilization review nurse in Arlington, VA earns between $51,000 and $93,000 annually. This compares to the national average utilization review nurse range of $47,000 to $89,000.

Average utilization review nurse salary in Arlington, VA

$69,000

What are the biggest employers of Utilization Review Nurses in Arlington, VA?

The biggest employers of Utilization Review Nurses in Arlington, VA are:
  1. Health Services
  2. Pharmacy
  3. Centerwell
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