Utilization Review Nurse - Prn

Requisition #: 625898
Location: Johns Hopkins Health Plans, Hanover, MD 21076
Category: Nursing
Schedule: Day Shift
Who you are:
As an experienced Utilization Review RN with Managed Care experience, you understand managed care delivery systems and utilization management. Working in a PRN capacity, you understand that importance of excellent communication skills, both verbal and written.
What you'll do:
All admissions assigned to your individual bin
Monitoring of assigned department bin(s)
Providing updates to the Medical Director at specified times
Checking the on call mailbox as assigned bu the Inpatient UM Supervisor in the Friday emails
What you'll bring:
3+ years' experience in Managed Care/Utilization Review in MCO is required
3+ years' experience as an acute care RN
Understanding of managed care delivery systems and utilization management
Excellent verbal/written communication skills to effectively interact and work collectively with enrollees, physicians, facility staff and management staff
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 RN licensure as applicable)
BSN is preferred
This is a PRN position for an experienced UR RN with MCO experience.
The rate of pay is $50/hour.
Note: The training for this position is full-time for 4 weeks (remote) M-F.
The hours once trained are Saturday & Sunday from 7:00 AM - 4:00 PM (Lunch from 12:00 PM - 1:00 PM). The PRN UR RN will work every other weekend
Who we are:
Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider-sponsored health plans and is poised for future growth.
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.
Please note: US citizenship is required for this position as it falls under the terms of a government contract (to ensure compliance with DODPSP).
This position is eligible for remote work.
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action 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.
Apply
To apply, visit https://jobs.hopkinsmedicine.org/job/utilization-review-nurse-prn-nursing-us-md-hanover-johns-hopki-625898-2a23f/
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