Utilization Management Opportunities

The Johns Hopkins Hospital offers two dynamic opportunities for nursing professionals to join our Performance Improvement Department.  Positions on our Utilization Management Team offer Physician Advisor interaction, peer appeals and special projects:

Utilization Review Specialist

1. Under general supervision of the Utilization Review Team Leader, perform Utilization Review activities which include concurrent and retrospective chart review to measure clinical performance and Utilization Management issues that affect reimbursement for a patient's hospital stay or visit.
2. Responsibilities include: medical record review, third party payer appeals, Utilization Management data analysis and reporting, Physician Advisor interaction, and special projects which are coordinated and directed by the Utilization Management Team Leader.
3. May design and initiate special projects as supervised by the Team Leader.
4. Apply now!
   

Utilization Review Team Leader

1. Oversees team performing Utilization Review activities which include concurrent and retrospective chart review to measure clinical performance and Utilization Review issues that affect reimbursement for a patient's hospital stay or visit.
2. Responsibilities: medical record review, third party payer appeals, Utilization Management data analysis and reporting, Physician Advisor interaction and special projects.
3. May design and initiate special projects as supervised by the Senior Director.
4. Apply now!