Utilization review nurse jobs in White Oak, MD - 222 jobs
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Utilization Review Nurse
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Nursing Residency (Transition to Practice Program)
Children's National Hospital 4.6
Utilization review nurse job in Washington, DC
About Our ANCC Practice Transition Accreditation Program (PTAP)
Transition to Practice Program is accredited with distinction as a Practice Transition Program by the American Nurses Credentialing Center's Commission on Accreditation in Practice Transition Programs.
The current sites included in this accreditation with distinction designation are:
Children's National Hospital (Sheikh Zayed Campus)
Children's National Hospital ED @ UMC
The current workplace settings included in this accreditation with distinction designation are:
Medical-Surgical
Oncology
Critical Care
Neonatal Intensive Care Unit (NICU)
Pediatric Intensive Care Unit (PICU)
Operating Room
Psychiatric
Emergency Department
Specialty Practice - Radiology
Program Details
The Transition to Practice Program (TPP) is a 12-month program designed to provide the nurse resident with an opportunity to transition into the role of a professional nurse under the guidance and support of our clinical nursing staff, nurse educators and program facilitators.
The program includes didactic and simulated learning combined with hands-on training in the clinical practice based environment, facilitating the nurse resident's transition from novice to competent nurse. Additionally, the program aims to create a strong social network that fosters a sense of community, support, resiliency building and professional development.
The TPP is offered twice a year to newly-licensed graduate nurses from an accredited nursing program with a passion for children. All new graduates with less than one year of clinical experience are eligible to participate in the program after obtaining licensure.
Applications for the winter 2025 TPP will be available September 30, 2024 and applications for the summer 2025 program will be available January 13, 2025. The duration a position is posted is determined by response to the position. All positions will be posted for a minimum of two weeks.
$70k-88k yearly est. 26d ago
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Travel Wound Ostomy Continence Nurse - $2,404 per week
Armstaffing
Utilization review nurse job in Baltimore, MD
ARMStaffing is seeking a travel nurse RN Wound Care for a travel nursing job in Baltimore, Maryland.
& Requirements
Specialty: Wound Care
Discipline: RN
Duration: 12 weeks
40 hours per week
Shift: 8 hours, days
Employment Type: Travel
Inpatient Wound Ostomy Continence Nurse (WOCN) RN - Day Shift
Location
Maryland
Assignment Duration
This is a 12-week contract position.
Schedule
5x8 hour shifts, Days (08:00 - 16:30), Monday through Friday
Job Description
The Inpatient Wound Ostomy Continence Nurse (WOCN) will provide specialized nursing care for patients with wounds, ostomies, and continence issues. This role requires an experienced RN with a focus on wound care and collaboration with multidisciplinary teams to promote optimal patient outcomes.
Responsibilities
Conduct comprehensive assessments of patients with wounds, ostomies, and continence issues.
Develop and implement individualized care plans based on patient needs.
Perform wound care procedures including dressing changes, debridement, and infection control.
Educate patients and families regarding ostomy care and wound management.
Participate in interdisciplinary rounds and collaborate with healthcare team members.
Document patient progress and outcomes in the electronic health record.
Required Experience / Certifications / Licensure
Registered Nurse (RN) license in Maryland or compact state.
Wound Care Certification (WCC) required.
BLS certification required.
Wound Ostomy Continence Nursing Certification (WOCN) preferred.
Minimum 1 year of relevant nursing experience in wound care.
Why ARMStaffing?
At ARMStaffing, we take care of our employees! We offer:
Health Benefits: Medical, Dental, Vision, Life, and more
Onboarding Made Easy: We handle physicals, titers, and more so you can focus on care
Clinical Support: In-house clinical team available to assist and advocate
401k Retirement Plan: Eligible after waiting period; 4% match with 5% contribution
Recruiter Matching: Get paired with a recruiter based on your location and specialty
Extras: Travel reimbursement, housing allowance, meals, referral bonuses, and more
We're not the only ones who think ARMStaffing should be your first choice. Here's why:
SIA's Top-50 Fastest Growing Healthcare Staffing Firms - 2019
SIA's Largest Healthcare Staffing Agencies in the U.S. - 2023
Top Workplace in the Lehigh Valley - 2022, 2023
Perfect scores for 'Name, Not a Number' and 'Recruiters' Personalities' on Highway Hypodermics
We've earned The Joint Commission's Gold Seal of Approval for healthcare staffing 15 years strong and counting!
Contract & local rates may vary based on location and applicant residency. Ask your ARMStaffing recruiter for details!
ARMStaffing Job ID #35364897. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN:Wound Care,07:00:00-15:00:00
About ARMStaffing
Allied Resources Medical Staffing (ARMStaffing) places the most qualified medical professionals in the industry, including: local and travel contract, temp-to-perm, per diem, and direct-hire personnel.
As a leader in medical staffing, we cover every segment of the healthcare market and take pride in our ability to exceed our clients' expectations. We accomplish this through our total dedication to our clients and field associates, our over 15 years of experience, a strong and diverse poor of medical professionals, and the high level of loyalty of our internal staff.
We also make it a point to develop and maintain close relationships with staffing and office managers to ensure clear communication and proper placements based on the client's criteria. This allows us to tailor our services to best suit the staffing needs of our clients, while placing our employees in positions that match their abilities and preferences.
Our goal is to offer unparalleled service to our valued healthcare clients, regardless of facility size or location, and to maintain a top-notch workforce of qualified, dedicated and medical professionals.
The Experts in Healthcare Recruiting
Local and travel contracts
Temp-to-perm employment
Direct-hire personnel
Per Diem
Staffing for every segment of the healthcare industry including, RNs, LPNs, and CNAs, and Allied Health Professionals
Long-term contracts, block scheduling and per diem staffing options
24-Hour customer service and on-call support 365 days a year
Full-time, registered nurse on staff to provide screening, background, and reference checks
Long-term and temporary career options with outstanding employee benefits
Medical Benefits
Company-matched 401K
$68k-130k yearly est. 3d ago
Travel Cardiac Cath Lab Nurse - $2,774 per week
ADEX Healthcare Staffing LLC 4.2
Utilization review nurse job in Arlington, VA
ADEX Healthcare Staffing LLC is seeking a travel nurse RN Cardiac Cath Lab for a travel nursing job in Arlington, Texas.
Job Description & Requirements
Specialty: Cardiac Cath Lab
Discipline: RN
40 hours per week
Shift: 10 hours, days
Employment Type: Travel
RN Position Job Notes:
Travel or Local Registered Nurse needed for ASAP start. A minimum of 2+ years of recent hospital bedside experience is required. Candidates must be able to start within 5 weeks. Opportunity for extension upon successful completion of the initial assignment. $750 referral bonus available.
Opportunity:
RN - Cardiac Cath Lab
Job Details:
• Provide nursing care for patients undergoing neuro intervention and interventional radiology procedures
• Work in Cardiac Cath Lab and Interventional Radiology setting
• On-call requirement 7 days a week, split between all staff
• No floating requirements
• Must have IR Lab experience with scrubbing and circulating in IR setting
• Perform all types of Cath lab and IR cases
• Assist with CT guided biopsies and drainages
• Support ultrasound guided biopsies and drainages
• Work with equipment including CT, Ultrasound, IR and Cath rooms
• Day shift staffing includes 3 RNs and 2 Techs
• Night shift on-call only
• Experience with neuro intervention procedures required
• Must be comfortable working in both cardiac catheterization and interventional radiology environments
Facility:
This healthcare facility operates a comprehensive cardiac catheterization lab and interventional radiology department providing advanced cardiovascular and interventional procedures. The facility features state-of-the-art equipment including CT, ultrasound, IR and cath lab rooms, supporting a wide range of diagnostic and therapeutic procedures. The department maintains a collaborative team environment with specialized staff providing 24/7 coverage for emergency and scheduled interventional cases.
Location:
Arlington, TX
Arlington offers an excellent location in the heart of the Dallas-Fort Worth metroplex, providing access to major urban amenities while maintaining a strong community feel. The area features numerous recreational opportunities, professional sports venues, and a thriving job market with convenient access to both Dallas and Fort Worth.
Adex Job ID #958494. Pay package is based on 10 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined.
About ADEX Healthcare Staffing LLC
ADEX has been placing healthcare professionals across the US since 2004. Originally founded in Atlanta, GA, the company's headquarters are now located in Tampa, FL. JCAHO certified since 2009.
Benefits
Referral bonus
$69k-105k yearly est. 1d ago
Travel Cardiac Cath Lab Nurse - $2,697 per week
American Traveler 3.5
Utilization review nurse job in Arlington, VA
American Traveler is seeking a travel nurse RN Cardiac Cath Lab for a travel nursing job in Arlington, Texas.
& Requirements
Specialty: Cardiac Cath Lab
Discipline: RN
40 hours per week
Shift: 10 hours, days
Employment Type: Travel
Job Description
American Traveler is seeking an experienced RN for a Cardiac Cath Lab position in Texas requiring a TX or compact RN license and recent specialty experience.
Responsibilities
Work in a hospital-based Cardiac Cath Lab setting
Typical shift is 7:00 AM to 5:30 PM
Responsible for care of patients undergoing cardiac catheterization procedures
Duties include assisting with invasive cardiac procedures and patient monitoring
Candidates must not have certifications expiring within the first 30 days of assignment
No Canadian Social Security Numbers will be accepted
Requirements
Active TX or compact RN license required
Minimum of 1 year of recent Cardiac Cath Lab RN experience
Current AHA or ARC BLS and ACLS certifications
No employment gaps of 90 days or more within the last 12 months
US Social Security Number and date of birth required for consideration
Benefits
High Pay and Bonuses
Medical, Dental and Vision Insurance with Day 1 Options
401(k) Plan
Weekly Payroll Deposit
Free Online CEUs
Generous Housing Allowance
Travel and Licensure Reimbursements
Non-taxed Per Diem and Subsidy
Traveler Rewards and Discounts
American Traveler Job ID #P-628231. Pay package is based on 10 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Cardiac Cath Lab
About American Traveler
With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.
With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.
American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.
With our team behind you, you can relax and enjoy a rewarding travel career.
$71k-150k yearly est. 2d ago
Nurse Navigator (RN) Urology
HH Medstar Health Inc.
Utilization review nurse job in Washington, DC
About the Job
The Nurse Navigator for Urology plays a critical role in guiding patients through diagnosis, treatment, and follow-up care for urologic conditions. Serving as a patient advocate and clinical resource, this role ensures seamless coordination across urology providers, surgical teams, and support services. The Nurse Navigator conducts patient assessments, provides education, facilitates timely referrals, and helps address barriers to care. By promoting patient engagement, enhancing the care experience, and supporting adherence to treatment plans, the Urology Nurse Navigator contributes to improved outcomes and the overall quality of care for patients at MedStar Health.
Primary Duties and Responsibilities
Coordinate and guide patients through the entire urology care continuum, including diagnosis, treatment, surgical procedures, and follow-up care.
Serve as a primary point of contact for patients and families, providing education, answering questions, and supporting decision-making throughout the care process.
Conduct patient assessments to identify medical, psychosocial, and logistical needs and develop individualized care plans.
Facilitate referrals to urology specialists, surgical teams, and support services within MedStar Health and community resources.
Monitor patient progress, follow up on appointments and treatment adherence, and address barriers to care.
Collaborate with multidisciplinary teams-including urologists, surgeons, nurses, social workers, and other providers-to ensure coordinated, patient-centered care.
Provide education on urologic conditions, treatment options, surgical preparation, and postoperative care.
Maintain accurate documentation in electronic health records (EHR) and track patient outcomes.
Support high-risk patients with complex needs, ensuring timely interventions and access to appropriate resources.
Participate in quality improvement initiatives, patient satisfaction efforts, and program development to enhance urology services.
Education
* Bachelor's degree in nursing required
* Master's degree in nursing preferred
Experience
Minimum of 2-5 years of clinical nursing experience, in urology, surgical services, or specialty outpatient care is required.
Experience providing patient education, care coordination, or case management in a healthcare setting.
Familiarity with managing patients with complex urologic conditions and treatment plans.
Demonstrated ability to collaborate with multidisciplinary teams, including physicians, surgeons, nurses, and support staff.
Experience using electronic health records (EHR) for documentation, care tracking, and outcome monitoring.
Prior experience in patient advocacy, navigation, or specialty care coordination is preferred
Licensure & Certifications
Active, unencumbered Registered Nurse (RN) license in the state of practice is required.
Current Basic Life Support (BLS) certification from the American Heart Association (AHA) is required.
Advanced Cardiac Life Support (ACLS) certification preferred but not required.
Certification in care coordination, case management (CCM, ACM), or specialty nursing (e.g., Urology Nursing Certification) is a plus.
Experience or certification in patient navigation or specialty care management is desirable.
This position has a hiring range of
USD $87,318.00 - USD $157,289.00 /Yr.
$87.3k-157.3k yearly 8d ago
Nurse Coordinator Pediatrics
Lifebridge Health 4.5
Utilization review nurse job in Baltimore, MD
Nurse Coordinator Pediatrics
Baltimore, MD
SINAI HOSPITAL
PEDS ENDOCRIN FPP
Part-time - Day shift - 8:00am-4:30pm
RN OTHER
93178
$40.12-$62.19 Experience based
Posted:December 16, 2025
Apply NowSave JobSaved
Summary
Who We Are:
LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to “improve the health of people in the communities we serve.” Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.
About the Role: (PART TIME-TWO DAYS PER WEEK) Performs in collaboration with appropriate clinical personnel, participates in the coordination of clinical practice activities in the office through the development and implementation of educational and orientation programs and clinical problem solving. Demonstrates the knowledge and skills necessary to provide care appropriate to the patient. Works in partnership with other staff members and physicians to proactively identify and provide for patient needs in accordance with LBH customer service standards and expectations along with The Joint Commission's standards and expectations. Key Responsibilities:
Clinical support and coverage
Triage and patient communication
Clinical procedures-assist with in-office procedures
Patient and family education
Prior authorizations-complete advanced level prior authorizations, track renewals
Medical Assistant oversight and clinical resource
Practice improvement and evidence based care-identify practice gaps/worklfow challenges and propose solutions and partner with leadership to implement updates
Vendor coordination
School forms and documenation-oversee completion of school related forms and ensure accuracy and timely turnaround
Requirements:
Education: Bachelor of Science in Nursing
Experience: 1-3 years of experience
License/Certification: Registered Nurse License in the State of Maryland, American Heart Association Basic Life Support CPR
Position located at Sinai Hospital and potentially Quarry Lake location
Additional Information
What We Offer:
Impact:
Join a team that values innovation and outcomes, delivering life-saving care to our youngest and most vulnerable patients.
Growth
: Opportunities for professional development, including tuition reimbursement and developing foundational skills for neonatal critical care leadership and advanced certification.
Support:
A culture of collaboration with resources like unit-based practice councils and advanced clinical education support - improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.
Benefits
: Competitive compensation (additional compensation such as overtime, shift differentials, premium pay, and bonuses may apply depending on job), comprehensive health plans, free parking, and wellness programs.
Why LifeBridge Health?
With over 14,000 employees, 130 care locations, and two million annual patient encounters, we combine strategic growth, innovation, and deep community commitment to deliver exceptional care anchored by five leading centers in the Baltimore region: Sinai Hospital of Baltimore, Grace Medical Center, Northwest Hospital, Carroll Hospital, and Levindale Hebrew Geriatric Center and Hospital.
Our organization thrives on a culture of CARE BRAVELY-where compassion, courage, and urgency drive every decision, empowering teams to shape the future of healthcare.
LifeBridge Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression. LifeBridge Health does not exclude people or treat them differently because of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression. Share:Apply Now
$78k-93k yearly est. 7d ago
Travel Emergency Department Charge Nurse - $1,921 per week
Anders Group 4.2
Utilization review nurse job in Clinton, MD
This position is for a travel Emergency Department Charge Nurse (RN) working 12-hour night shifts over a 13-week assignment in Clinton, Maryland. The role involves providing emergency healthcare services while supported by a staffing agency that offers comprehensive benefits including health insurance, continuing education, and travel reimbursements. The job is located at MedStar Southern Maryland Hospital, emphasizing patient care and rapid response in an emergency setting.
Anders Group is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Clinton, Maryland.
Job Description & Requirements
Specialty: ED - Emergency Department
Discipline: RN
Start Date:
Duration: 13 weeks
36 hours per week
Shift: 12 hours, nights
Employment Type: Travel
Anders Group Job ID #954131. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Registered Nurse - ER @ MedStar Southern Maryland Hospital Rapid Response
About Anders Group
WHY ANDERS?
Anders Group is a Joint Commission accredited staffing agency and stands out from other agencies by our commitment to making sure our travelers are given the best customer service. Our team works hard to find the best jobs with the most aggressive rates!
Anders Group offers rewarding assignments and competitive compensation packages, nationwide!
We offer the following benefits from day one:
Health Insurance, Including a Buy-up Option Dental Insurance Vision Insurance
Life Insurance
401(k)
Licensure Reimbursement
Premium Pay Packages
CEU Reimbursements
Daily Per Diems
Travel Reimbursements
Rental Car Allowances
Continuing Education Resources
Referral Bonus
And Many More!
THE ANDERS DIFFERENCE
You're committed to providing exceptional healthcare. We're committed to you.
Anders Group was founded by a team of healthcare recruiters who had built strong relationships with healthcare facilities and professionals nationwide. As staffing firms shifted their focus to numbers and margins, these recruiters saw a need for a company to take a different approach to staffing. Anders Group was founded in 2010 to do just that. We focus on individual and facility goals to make quality placements. Great people working with great facilities make for the best placements. Through our focus on providing the best experience to Allied and Nursing health care professionals, Anders Group has grown to be a top staffing firm in Healthcare. We look forward to working with you!
Benefits
Medical benefits
Dental benefits
Vision benefits
Life insurance
401k retirement plan
License and certification reimbursement
Continuing Education
Referral bonus
Keywords:
travel nurse, emergency department nurse, registered nurse, ED nurse, travel nursing jobs, healthcare staffing, emergency care, nursing travel assignment, charge nurse, hospital nursing
$69k-133k yearly est. 2d ago
Wellness Nurse
Brightview Senior Living, LLC 4.0
Utilization review nurse job in Herndon, VA
Work witha great team where you feel appreciated and make a difference!
Responsibilities:
Provide warm and engaging personal care services, assistance, support and companionship.
Administer or assist with medication for residents according to the Resident Care Plan.
Engage residents while checking on their wellbeing and communicate changes in condition or Care Plan.
Inspire your team and collaborate with the Health Services Director in assessing and documenting resident assessments at state or Brightview specified intervals.
Salary range: USD $32.75 - USD $39.25 /Hr.
Compensation Disclosure:
$31.75-$38.00/hour
The salary range mentioned above reflects the potential pay for this role and does not include bonuses or additional incentives (if applicable), nor does it include the value of our benefit program. Offers will consider factors like experience, qualifications, location, community size (if relevant), certifications/training, etc. Brightview regularly reviews and adjusts compensation ranges.
Qualifications:
You have a positive attitude and love working with people!
A graduate of a state approved school of nursing.
A current state license as a Registered or Practical/Vocation Nurse.
Minimum of one year of experience in assisted living, hospice, home health, acute or long-term care environment.
Why work at Brightview?:
Discover the Brightview Senior Living Difference!
1. Dedicated to Excellence: We lead the industry with a passion for delivering top-notch services and groundbreaking care.
2. Embracing Community: Join a supportive and inclusive environment that prioritizes your professional growth, development and advancement.
3. Impactful Work: Make a meaningful difference in the lives of our seniors, contributing to their joy and well-being every day.
4. Comprehensive Benefits: Enjoy competitive salaries, health, vision and dental insurance options, retirement plans, tuition reimbursement, employee assistance programs and many more benefits that prioritize your well-being.
5. A Place to Flourish: Embrace diversity, foster innovation, and access the tools and resources for personal and professional growth. Join our vibrant team at Brightview Senior Living and be valued as an integral part of our community.
Equal Opportunity Employer
At Brightview, we believe that diversity of thought, experience, perspective, and backgrounds makes us stronger. We welcome and celebrate all that makes us unique and we choose not to discriminate on the basis of race, color, creed, religion, sex, pregnancy, age, marital status, national origin, citizenship status, military status, physical or mental disability, sexual orientation, genetic information or any other characteristic protected by law or not related to the specific requirements of a particular role. We are, by choice and without question, an equal opportunity employer.
For Massachusetts Applicants: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
$31.8-38 hourly 1d ago
Utilization Review Nurse
Medstar Research Institute
Utilization review nurse job in Baltimore, MD
About the Job * Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.
Primary Duties and Responsibilities
* Conducts admission concurrent and retrospective case reviews to meet hospital objectives of high-quality patient care in the most efficient way
* Strives to meet the department goals adheres to organizational policies procedures and quality standards. Complies with rules and regulations set forth by the governmental and accrediting agencies.
* Collaborates with medical staff physician advisor social workers and other ancillary hospital disciplines to meet patients' health care needs in the most cost-effective way.
* Performs patients' medical record reviews document pertinent information and communicate with third party payors in a timely fashion to ensure proper hospital reimbursement and eliminate unnecessary denials.
* Implements strategies to avoid potential denials by communicating with all the key stakeholders including attending physician.
* If necessary non-coverage ABN MOON letters and other appropriate documents as per organizational governmental and accrediting organizations policies and regulations.
* Actively participates in IDRs Length of Stay and other meetings as per hospital policies.
* Identifies potential risks pertaining to patients' care and communicates with appropriate hospital discipline including risk management quality safety and infection control.
* Serves as a resource to the health care team by educating the health care team through in-services staff meetings and formal educational settings in areas of utilization management.
* Demonstrate current knowledge of State and Federal regulatory requirements as it pertains to the utilizationreview process.
* Identifies dynamics of neglect/abuse and reports to the appropriate in-house departments and governmental agencies.
Minimal Qualifications
Education
* Associate's degree in Nursing required and
* Bachelor's degree in Nursing preferred
Experience
* 3-4 years 3 years experience in acute care setting required and
* 1-2 years 2 years experience in case management insurance UR/or related experience preferred
Licenses and Certifications
* RN - Registered Nurse - State Licensure and/or Compact State Licensure In the District of Columbia or the state of Maryland depending on work location Upon Hire required and
* CCM - Certified Case Manager Upon Hire preferred
Knowledge Skills and Abilities
* Excellent problem-solving skills and ability to exercise independent judgment.
* Business acumen and leadership skills.
* Strong verbal and written communication skills with ability to effectively interact with all levels of management internal departments and external agencies.
* Working knowledge of various computer software applications.
This position has a hiring range of
USD $89,065.00 - USD $162,801.00 /Yr.
* Only candidates living in the Greater Baltimore region will be considered for the position *
General Summary of Position
Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.
Primary Duties and Responsibilities
* Conducts admission concurrent and retrospective case reviews to meet hospital objectives of high-quality patient care in the most efficient way
* Strives to meet the department goals adheres to organizational policies procedures and quality standards. Complies with rules and regulations set forth by the governmental and accrediting agencies.
* Collaborates with medical staff physician advisor social workers and other ancillary hospital disciplines to meet patients' health care needs in the most cost-effective way.
* Performs patients' medical record reviews document pertinent information and communicate with third party payors in a timely fashion to ensure proper hospital reimbursement and eliminate unnecessary denials.
* Implements strategies to avoid potential denials by communicating with all the key stakeholders including attending physician.
* If necessary non-coverage ABN MOON letters and other appropriate documents as per organizational governmental and accrediting organizations policies and regulations.
* Actively participates in IDRs Length of Stay and other meetings as per hospital policies.
* Identifies potential risks pertaining to patients' care and communicates with appropriate hospital discipline including risk management quality safety and infection control.
* Serves as a resource to the health care team by educating the health care team through in-services staff meetings and formal educational settings in areas of utilization management.
* Demonstrate current knowledge of State and Federal regulatory requirements as it pertains to the utilizationreview process.
* Identifies dynamics of neglect/abuse and reports to the appropriate in-house departments and governmental agencies.
Minimal Qualifications
Education
* Associate's degree in Nursing required and
* Bachelor's degree in Nursing preferred
Experience
* 3-4 years 3 years experience in acute care setting required and
* 1-2 years 2 years experience in case management insurance UR/or related experience preferred
Licenses and Certifications
* RN - Registered Nurse - State Licensure and/or Compact State Licensure In the District of Columbia or the state of Maryland depending on work location Upon Hire required and
* CCM - Certified Case Manager Upon Hire preferred
Knowledge Skills and Abilities
* Excellent problem-solving skills and ability to exercise independent judgment.
* Business acumen and leadership skills.
* Strong verbal and written communication skills with ability to effectively interact with all levels of management internal departments and external agencies.
* Working knowledge of various computer software applications.
$89.1k-162.8k yearly 6d ago
Staff Nurse
Luminis Health
Utilization review nurse job in Annapolis, MD
Contributes to the provision of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective of the health care team. Functions as a competent member of the health care team.
1. Clinical Decision Making/Judgment
Demonstrates clinical nursing knowledge and skill in the specialization of the unit.
Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care.
Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes.
Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies.
Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients.
Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals.
Efficiently implements the patients plan of care in accordance with applicable standards, policies, procedures and guidelines.
Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills.
Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions.
2. Nurse-Patient Family Relationships
Demonstrates the ability to assess the patients/familys learning needs, readiness to learn, learning style, and presence of barriers to learning.
Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards.
Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients.
Provides direct patient care to patients and families in a culturally, developmentally and ethically appropriate manner.
Plans of care address the physical, psychosocial, spiritual and learning needs of the patient/family.
3. Clinical Scholarship
Participates in QI, CPI and risk management activities at the unit, department or organizational level.
Demonstrates the ability to effectively perform and improve all processes in order to achieve excellence with regard to Luminis Healths quality standards and benchmarks.
Supports the use of evidence based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment.
4. Clinical Leadership
Participates in unit shared governance according to departmental standards.
Participates in the education and orientation of new staff.
Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes.
Employs real time computer documentation when completing patient record.
Educational/Experience Requirements:
Graduate of an accredited school of nursing
Adherence to the credentialing requirements of Luminis Health as stated in the nursing bylaws.
Where applicable, completion of a BSN is required within 5 years of date of hire
Required License/Certifications:
Current licensure as a registered nurse by the Maryland Board of Nursing
BLS - American Heart Association Health Provider
If serving as a bilingual/multilingual interpreter, certification in Medical Interpretation is required to perform the duties of a qualified interpreter.
Additional requirements by department:
PALS Requirement:
The following department(s) require PALS: Pediatrics Unit, Postanesthesia Care Unit, Endoscopy, Procedural Care Unit, Interventional Radiology.
ACLS Requirement:
The following department(s) require ACLS: Heart and Vascular Unit, Neuro Care Unit, ICU/IMU, Interventional Radiology, Postanesthesia Care Unit, Progressive Care Unit, Resource Nurses, Emergency Department, Prep, Telemetry, Outpatient Infusion, Vascular Access Team, DRCC Bowie, Observation Unit, Endoscopy, Procedural Care Unit, Cardiac Cath Lab, Flex Nursing Unit, ICU, Operating Room (LHDCMC only), Cardiac Cath Lab, Observation Unit, DCMC IP Mental Health, and Edwards Pre-Op and PACU.
Chemotherapy/Immunotherapy Certification requirement:
Certification within 6 months of hire if experienced or within 1 year for new graduate nurse
The following department(s) require a Chemotherapy/Immunotherapy Certification: Oncology Unit
NRP - Neonatal Resuscitation requirement:
The following department(s) require NRP - Neonatal Resuscitation: Mother and Baby Unit, Neonatal Intensive Care Unit, Labor and Delivery Unit, and Women's Surgical Unit.
BLS requirement:
The following department(s) require BLS: Employee Health, Performance Improvement, Special Pathogens Unit, Neuro Care Unit, Pre-Anes Testing, Wound Care Center, Medical Staff Office, Nursing Administration, Nursing Graduate Program, Women's Surgical Unit, Joint and Spine Unit, 4 Medical, IV Therapy, Nursing Quality and Research, HSCRC Nursing Grant, Flex Nursing Unit, ICU, Operating Room, Short Stay Unit, Postanesthesia Care Unit, Progressive Care Unit, 4TH FLOOR, DCH 3 East Med Surg Telemetry, 3 West Oncology, Emergency Room, Oncology Unit and 2 EAST OBS.
Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens.
Physical Demands -
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.
The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.
Pay Range
$34-$54 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.
$19k-55k yearly est. 2d ago
Utilization Review Nurse (RN)
University of Maryland Medical System 4.3
Utilization review nurse job in Towson, MD
When you come to the University of Maryland St. Joseph Medical Center, you're coming to more than simply a beautiful 37-acre, 218-bed suburban Baltimore, Maryland campus. You're embarking on a professional journey that encourages opportunities, values a team atmosphere, and makes convenience and flexibility a priority. Joining our team of healthcare professionals means you'll be contributing to a locally and nationally recognized institution. UM St. Joseph has been recognized by The Leapfrog Group as a grade ‘A' hospital and by U.S. News & World Report as #3 in both the state and Baltimore Metro area, making UM St. Joseph the highest-ranking community hospital in Maryland. In addition, we've been consistently recognized as a top employer by Baltimore magazine.
Job Description
Work Schedule * 8:00am - 4:30pm - Full time hybrid position with weekend rotation required.
The UtilizationReviewNurse (RN) coordinates the care and service of selected patient populations across the continuum. He/ she works collaboratively with physicians and other members of the health care team to achieve the highest quality clinical outcomes with the most cost effective use of available resources. The UtilizationReviewNurse (RN) assumes responsibility for an interdisciplinary process which assesses, plans, implements, monitors and measures the effectiveness of interventions to meet patients' treatment and transitional needs.
Qualifications
Education
* 2 year / Associate's Degree (Required)
* High School Diploma or GED (Required) 4 year / Bachelor's Degree (Preferred)
Certification / Licensure / Registration
*State Registered Nurse License (Required)
MCG Or InterQual experience (Preferred)
CCM Case Management Certification (Preferred) Experience and Skills
*2 - 4 years Familiarity with health care reimbursement systems (Required)
*4 - 6 years Acute care hospital or similar venue. (Required) 2 - 4 years Case management, discharge planning or utilization management (Preferred)
Required Skills: Strong Verbal Communications Skills, Strong Written Communications Skills, Excellent Interpersonal Skills, Medical Terminology
Additional Information
.All your information will be kept confidential according to EEO guidelines.
Compensation:
Pay Range: $39.52 - $50.65
Other Compensation (if applicable): N/A
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].
Formulary Strategy & UtilizationReview 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
Nurse Case Manager Sr
Elevance Health
Utilization review nurse job in Washington, DC
Location: Washington, DC. This role requires associates to be in-office 4 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of remote work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The Nurse Case Manager Sr will be responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning.
How you will make an impact:
Ensures member access to services appropriate to their health needs.
Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
Coordinates internal and external resources to meet identified needs.
Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
Negotiates rates of reimbursement, as applicable.
Assists in problem solving with providers, claims or service issues.
Assists with development of utilization/care management policies and procedures, chairs and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and participates in interdepartmental and/or cross brand workgroups.
May require the development of a focused skill set including comprehensive knowledge of specific disease process or traumatic injury and functions as preceptor for new care management staff.
Participates in department audit activities.
Minimum Requirements:
Requires BA/BS in a health related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
Current, unrestricted RN license in applicable state(s) required.
Multi-state licensure is required if this individual is providing services in multiple states.
Preferred Skills, Capabilities and Experiences:
Certification as a Case Manager is preferred.
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $89,608- $134,412
Locations: District of Columbia (Washington, DC)
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws
.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Job Level:
Non-Management Exempt
Workshift:
Job Family:
MED > Licensed Nurse
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$89.6k-134.4k yearly Auto-Apply 60d+ ago
Nurse Case Mgr I (US)
Carebridge 3.8
Utilization review nurse job in Washington, DC
Nurse Case Manager I Location: Washington, DC. This role requires associates to be in-office 4 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of remote work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Schedule: Monday-Friday 8:00AM-5:00PM or 8:30AM-5:30PM EST
The Nurse Case Manager I will be responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning.
How you will make an impact:
* Ensures member access to services appropriate to their health needs. Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
* Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
* Coordinates internal and external resources to meet identified needs.
* Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
* Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
* Negotiates rates of reimbursement, as applicable.
* Assists in problem solving with providers, claims or service issues.
Minimum Requirements:
* Requires BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
* Current, unrestricted RN license in applicable state(s) required.
* Multi-state licensure is required if this individual is providing services in multiple states.
Preferred Skills, Capabilities & Experiences:
* Certification as a Case Manager and a BS in a health or human services related field preferred.
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $75,440 - $113,160
Locations: District of Columbia (Washington, DC)
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$75.4k-113.2k yearly Auto-Apply 60d+ ago
Travel Outpatient BMT Nurse Coordinator - $2,261 per week
Prime Staffing 4.4
Utilization review nurse job in Washington, DC
Prime Staffing is seeking a travel nurse RN Hematology / Oncology for a travel nursing job in Washington, District of Columbia.
Job Description & Requirements
Specialty: Hematology / Oncology
Discipline: RN
Duration: 13 weeks
40 hours per week
Shift: 8 hours
Employment Type: Travel
About the Position
Specialty: RN - Psych
Experience: 1-2 years in psychiatric or behavioral health nursing preferred
License: Active State or Compact RN License
Certifications: BLS - AHA
Must-Have: Strong crisis intervention skills, ability to manage behavioral emergencies
Description: The Psychiatric RN provides direct care to patients with mental health or substance use disorders. Responsibilities include conducting assessments, administering medications, implementing care plans, supporting therapeutic activities, and ensuring a safe environment. Collaborates closely with behavioral health teams and maintains accurate patient documentation.
Requirements
Required for Onboarding:
Active RN License
BLS
CPI or PMAB (as applicable)
Prime Staffing Job ID #35127191. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN:Psych,08:00:00-16:00:00
About Prime Staffing
At Prime Staffing, we understand the importance of finding the perfect fit for both our clients and candidates. Prime Staffing utilizes a unique matchmaking approach, providing the most qualified contingent staffing to our clients, and the most competitive contracts to our workforce. Our experienced team takes the time to get to know both our clients and candidates, their needs, and preferences, to ensure that each placement is a success.
We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire placements. Our extensive network of qualified candidates includes nurses, allied healthcare professionals, corporate support professionals and executives.
$84k-102k yearly est. 5d ago
Travel Emergency Department Charge Nurse - $2,066 per week
American Traveler 3.5
Utilization review nurse job in Clinton, MD
This role is for a Travel Emergency Department Charge Nurse (RN) working night shifts in a busy acute care hospital. The position requires at least two years of recent ED experience, strong triage and supervisory skills, and certifications including ACLS, BLS, NIHSS, and PALS. Benefits include high pay, housing allowance, insurance coverage, 401(k) plan, and professional support from American Traveler.
American Traveler is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Clinton, Maryland.
& Requirements
Specialty: ED - Emergency Department
Discipline: RN
Start Date:
Duration: 13 weeks
36 hours per week
Shift: 12 hours, nights
Employment Type: Travel
Job Description
American Traveler is seeking an experienced RN for a night shift Emergency Dept position requiring prior travel experience and strong triage skills.
Responsibilities
Work in the Emergency Department of an acute care hospital
Cares for patients in a busy ED setting with an average census of at least 125 patients per day
Nurse-to-patient ratio is 1:4
Night shift schedule: 3x12 hour shifts, 19:00-07:30
Required to orient and work in the charge RN role
May be exposed to COVID patients
Electronic Medical Record system is Cerner; experience is preferred but not required
Nurses may be required to cover charge RN shifts as part of assignment responsibilities
Scrub color is purple; uniforms are not provided
RTO during a contract will not be approved for more than 8 days and must still allow completion of all weekly hours
Travelers who previously worked for MedStar must have been gone for at least one year before returning
Mandatory completion of online modules, including some prior to start and potentially during orientation
Manager interview may or may not occur as part of hiring process
Local candidates accepted but paid at a different rate
Requirements
Active MD or Compact RN license required
Minimum of 2 years recent Emergency Dept experience
Must have completed at least 1 prior travel assignment
Certifications required: ACLS, BLS, NIHSS, and PALS
Must have recent experience in an ED with at least 125 patients per day within the past 8 months
Skilled in triage, IV starts, and phlebotomy
Expert prioritization and organizational skills required for a fast-paced ER environment
Two supervisor references required for consideration
Flu vaccine required
Benefits
High Pay and Bonuses
Medical, Dental and Vision Insurance with Day 1 Options
401(k) Plan
Weekly Payroll Deposit
Free Online CEUs
Generous Housing Allowance
Travel and Licensure Reimbursements
Non-taxed Per Diem and Subsidy
Traveler Rewards and Discounts
American Traveler Job ID #P. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Emergency Dept
About American Traveler
With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.
With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.
American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.
With our team behind you, you can relax and enjoy a rewarding travel career.
Keywords:
Travel Nurse, Emergency Department, Charge Nurse, RN, Triage Skills, ACLS, BLS, NIHSS, PALS, Travel Nursing Benefits
$74k-158k yearly est. 2d ago
Utilization Review Nurse
HH Medstar Health Inc.
Utilization review nurse job in Baltimore, MD
About the Job * Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital disciplines to ensure high-quality patient care in the most efficient way.
Primary Duties and Responsibilities
* Conducts admission concurrent and retrospective case reviews to meet hospital objectives of high-quality patient care in the most efficient way
* Strives to meet the department goals adheres to organizational policies procedures and quality standards. Complies with rules and regulations set forth by the governmental and accrediting agencies.
* Collaborates with medical staff physician advisor social workers and other ancillary hospital disciplines to meet patients' health care needs in the most cost-effective way.
* Performs patients' medical record reviews document pertinent information and communicate with third party payors in a timely fashion to ensure proper hospital reimbursement and eliminate unnecessary denials.
* Implements strategies to avoid potential denials by communicating with all the key stakeholders including attending physician.
* If necessary non-coverage ABN MOON letters and other appropriate documents as per organizational governmental and accrediting organizations policies and regulations.
* Actively participates in IDRs Length of Stay and other meetings as per hospital policies.
* Identifies potential risks pertaining to patients' care and communicates with appropriate hospital discipline including risk management quality safety and infection control.
* Serves as a resource to the health care team by educating the health care team through in-services staff meetings and formal educational settings in areas of utilization management.
* Demonstrate current knowledge of State and Federal regulatory requirements as it pertains to the utilizationreview process.
* Identifies dynamics of neglect/abuse and reports to the appropriate in-house departments and governmental agencies.
Minimal Qualifications
Education
* Associate's degree in Nursing required and
* Bachelor's degree in Nursing preferred
Experience
* 3-4 years 3 years experience in acute care setting required and
* 1-2 years 2 years experience in case management insurance UR/or related experience preferred
Licenses and Certifications
* RN - Registered Nurse - State Licensure and/or Compact State Licensure In the District of Columbia or the state of Maryland depending on work location Upon Hire required and
* CCM - Certified Case Manager Upon Hire preferred
Knowledge Skills and Abilities
* Excellent problem-solving skills and ability to exercise independent judgment.
* Business acumen and leadership skills.
* Strong verbal and written communication skills with ability to effectively interact with all levels of management internal departments and external agencies.
* Working knowledge of various computer software applications.
This position has a hiring range of
USD $89,065.00 - USD $162,801.00 /Yr.
$89.1k-162.8k yearly 6d ago
Psychiatric Staff Nurse
Luminis Health
Utilization review nurse job in Annapolis, MD
Provides psychiatric nursing care including intake, assessment and interventions (including crisis interventions). Provides care for psychiatric patients including medication administration and medication management as needed. For the inpatient unit, initiates the interdisciplinary care plan. For the mental health emergency department, collaborates with ED and MH team with final disposition authorized by the Emergency Department MD and Mental Health Clinician. Assists with discharge planning and education. Collaborates with all colleagues and communicates in a professional manner.
Essential Job Duties:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Clinical Decision Making/Judgment:
Demonstrates clinical nursing knowledge and skill in the specialization of the unit
Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families
Demonstrates the ability to utilize all applicable laws and regulations, policies, standards, guidelines and evidence-based practice in the provision of patient/family care
Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes
Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies
Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients
Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals;
Efficiently implements the patient's plan of care in accordance with applicable standards, policies, procedures and guidelines
Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills
Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions.
Nurse-Patient Family Relationships:
Demonstrates the ability to assess the patient/family learning needs, readiness to learn, learning style, and presence of barriers to learning
Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards
Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients
Provides direct patient care to patients and families in a culturally, developmentally and ethically appropriate manner
Plans of care address the physical, psychosocial, spiritual and learning needs of the patient/family.
Clinical Scholarship:
Participates in QI, CPI and risk management activities at the unit, department or organizational level
Demonstrates the ability to effectively perform and improve all processes in order to achieve excellence with regard to AAMC's quality standards and benchmarks
Supports the use of evidence based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment.
Clinical Leadership:
Participates in unit shared governance according to departmental standards
Participates in the education and orientation of new staff
Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes
Employs real time computer documentation when completing patient record.
Performs charge nurse duties as needed and supervises other nursing staff as needed.
Educational/Experience Requirements:
1 - 3 years-Psychiatric Nursing.
Successful completion of approved nursing program. If not BSN, actively working on completion
Required License/Certifications:
Current licensure as a registered nurse by the Maryland Board of Nursing.
American Heart Association Healthcare Providers BLS.
Adherence to credentialing requirements of Luminis Health as stated in the nursing bylaws.
Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens and agitated patients.
Physical Demands - Medium Work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move object.
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.
The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.
Pay Range
$35-$54 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.
$19k-55k yearly est. 2d ago
Utilization Review Nurse (RN)
University of Maryland Medical Center Baltimore Washington 4.3
Utilization review nurse job in Towson, MD
Work Schedule * 8:00am - 4:30pm - Full time hybrid position with weekend rotation required. The UtilizationReviewNurse (RN) coordinates the care and service of selected patient populations across the continuum. He/ she works collaboratively with physicians and other members of the health care team to achieve the highest quality clinical outcomes with the most cost effective use of available resources. The UtilizationReviewNurse (RN) assumes responsibility for an interdisciplinary process which assesses, plans, implements, monitors and measures the effectiveness of interventions to meet patients' treatment and transitional needs.
Company Description
When you come to the University of Maryland St. Joseph Medical Center, you're coming to more than simply a beautiful 37-acre, 218-bed suburban Baltimore, Maryland campus. You're embarking on a professional journey that encourages opportunities, values a team atmosphere, and makes convenience and flexibility a priority. Joining our team of healthcare professionals means you'll be contributing to a locally and nationally recognized institution. UM St. Joseph has been recognized by The Leapfrog Group as a grade 'A' hospital and by U.S. News & World Report as #3 in both the state and Baltimore Metro area, making UM St. Joseph the highest-ranking community hospital in Maryland. In addition, we've been consistently recognized as a top employer by Baltimore magazine.
Qualifications
Education
* * 2 year / Associate's Degree (Required)
* * High School Diploma or GED (Required) 4 year / Bachelor's Degree (Preferred)
Certification / Licensure / Registration
* *State Registered Nurse License (Required)
* MCG Or InterQual experience (Preferred)
* CCM Case Management Certification (Preferred) Experience and Skills
* *2 - 4 years Familiarity with health care reimbursement systems (Required)
* *4 - 6 years Acute care hospital or similar venue. (Required) 2 - 4 years Case management, discharge planning or utilization management (Preferred)
Required Skills: Strong Verbal Communications Skills, Strong Written Communications Skills, Excellent Interpersonal Skills, Medical Terminology
Additional Information
.All your information will be kept confidential according to EEO guidelines.
Compensation:
Pay Range: $39.52 - $50.65
Other Compensation (if applicable): N/A
Review the 2025-2026 UMMS Benefits Guide
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$39.5-50.7 hourly 27d ago
Travel Transplant Nurse Coordinator - $2,208 per week
Prime Staffing 4.4
Utilization review nurse job in Washington, DC
Prime Staffing 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
Employment Type: Travel
About the Position
Specialty: RN - Transplant
Experience: 1-2 years of experience in transplant, surgical, or med/surg nursing preferred
License: Active State or Compact RN License
Certifications: BLS - AHA; ACLS preferred
Must-Have: Knowledge of organ transplant procedures and post-op care; ability to educate and support transplant patients and their families
Description: The Transplant RN provides specialized care to patients undergoing organ transplant procedures. Responsibilities include coordinating pre- and post-transplant care, monitoring for signs of rejection or infection, administering immunosuppressive medications, and collaborating with the transplant team for optimal outcomes.
Requirements
Required for Onboarding:
Active RN License
BLS
ACLS(preferred)
Prime Staffing Job ID #35445667. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN:Transplant,08:00:00-16:00:00
About Prime Staffing
At Prime Staffing, we understand the importance of finding the perfect fit for both our clients and candidates. Prime Staffing utilizes a unique matchmaking approach, providing the most qualified contingent staffing to our clients, and the most competitive contracts to our workforce. Our experienced team takes the time to get to know both our clients and candidates, their needs, and preferences, to ensure that each placement is a success.
We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire placements. Our extensive network of qualified candidates includes nurses, allied healthcare professionals, corporate support professionals and executives.
How much does a utilization review nurse earn in White Oak, MD?
The average utilization review nurse in White Oak, MD earns between $50,000 and $91,000 annually. This compares to the national average utilization review nurse range of $47,000 to $89,000.
Average utilization review nurse salary in White Oak, MD