Registered Nurse – Utilization Review

This is a fully remote position, open to applicants in Maryland.

📋 Description

• Evaluate admissions and service requests to ensure that every patient receives appropriate medical necessity at the right time.

• Navigate complex patient experiences through case management and consultation.

• Address documentation and reimbursement challenges for the frontline care team.

• Work collaboratively with the healthcare team to develop safe and effective discharge plans.

• Ensure adherence to federal and payer regulations.

⛳️ Requirements

• Registered Nurse credential from the Maryland Board of Nursing must be obtained prior to the hire date or job transfer date.

• Diploma from an accredited nursing school/college or the required professional licensure must be in place at the time of hire.

• Previous experience in Utilization Management, Case Management, or Clinical Documentation Improvement in a healthcare environment is preferred.

• Work schedule is Monday through Friday from 8:00 AM to 4:30 PM.

• Weekend rotation is required once per month.

• Employer does not participate in E-Verify, thus STEM OPT candidates cannot be employed.

🏝️ Benefits

• Comprehensive health coverage including medical, dental, vision, prescription coverage, and HSA/FSA options.

• Employer-matched 403(b) retirement plan.

• Resources for planning and hardship support.

• Disability and life insurance options.

• Pro-rated paid time off (PTO) and holidays.

• Ascension-paid tuition through Vocare.

• Tuition reimbursement program.

• Opportunities for ongoing professional development and online learning.

• Employee Assistance Program available.

• Counseling and peer support services.

• Resources for spiritual care and stress management.

• Parental leave policy.

• Adoption assistance and family benefits offered.

• Optional legal and pet insurance available.

• Transportation savings program.