Utilization Review Manager - Home Care ensures quality and level of care for patients are up to established standards and comply with federal, state, and local regulations. Investigates and resolves reports of inappropriate care. Being a Utilization Review Manager - Home Care may require a bachelor's degree. Typically reports to a head of a unit/department. To be a Utilization Review Manager - Home Care typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)
General Summary
This is a PRN position with a requirement to work a minimum 2 weekend shifts per month & 1 holiday per year.
MUST have 3-5 years clinical experience in a healthcare setting and have previous Utilization Management experience.
Under general supervision, provides utilization review for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient’s need for outpatient or inpatient care as well as the appropriate level of care. The role requires interfacing with the case managers, medical team, other hospital staff, physician advisors and payers.
Principal Responsibilities and Tasks
Our growing community hospital serving Maryland’s Charles County offers all of the services and amenities of a bigger metro hospital with the personal attention of our caring staff. At University of Maryland Charles Regional Medical Center (UM CRMC), our talented and diverse groups of professionals represent our strength. Through teamwork and a collaborative work environment, we proudly serve our patients and our community with unwavering commitment. It’s our passion for people that motivates us to do great work every single day.
We are consistently named among the top 100 Best Places to Work in Maryland. Employees have the opportunity to grow professionally in a supportive and stimulating environment. Our excellent employee benefits support a healthy, balanced lifestyle.
All your information will be kept confidential according to EEO guidelines.
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