Utilization Management Specialist

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Make it happen at Hopkins!

This is a remote position. Our organization is registered for remote work in the following states: MD, VA, DC, FL, and PA.

Johns Hopkins Medicine, a nonprofit, combines over 125 years of commitment to community care with groundbreaking research, teaching and medical services to patients worldwide. Johns Hopkins Medicine operates six academic and community hospitals, four health care and surgery centers, more than six ambulatory surgery centers and has more than 2.8 million outpatient encounters per year.

What you will do:

Under the general supervision of the UM Team Manager, this individual performs UM activities which includes admission review, concurrent review, retrospective chart review and clinical systems review to measure clinical performance and UM issues that affect reimbursement for the patient's hospital stay or visit. Responsibilities include medical record review, providing clinical information to the payer, UM data collection and reporting, clinical team interaction, Physician Advisor interaction and special projects which are coordinated and directed by the UM Team Manager. May design and initiate special projects as supervised by the Team Manager.

What awaits you!

You can enjoy an environment that is continually recognized as one of the best workplaces in the world.

Click or copy and paste the link below to watch this Johns Hopkins Medicine Virtual Tour to learn more about us!

https://www.youtube.com/watch?v=KnNaPzR-AEE

In addition to working with some of the best and brightest in the medical field, we offer our employees generous benefits:

• Work-life balance - This is a remote position!
• 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 will bring:

• Completion of an accredited Nursing Program (RN) or LCSW required, BSN preferred.
• Minimum of five years of nursing experience or five years of licensed social work experience, with preference for Utilization Management, Care Management, Appeals and/or clinical experience.
• Valid state Nursing licensure or Social Work License for Psychiatry required.

Salary Range: Minimum 42.34/hour - Maximum 65.62/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.

JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins!

Diversity and Inclusion are Johns Hopkins Medicine Core Values. 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.