General Summary

Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory agencies to assure compliance with regulatory and reimbursement requirements. The position is goal-oriented with a high level of accountability correlated to maximizing reimbursement and minimizing denials. Partial remote work will be considered upon successful completion of orientation and discretion of the manager.

Mission

All employees are responsible for extending the mission and values of Baltimore Washington Medical Center by dedicating oneself to providing the highest quality healthcare services to the communities we serve.

Reporting Relationships

Reports to the Manager of Utilization Review 

Experience the highest level of appreciation at UM Baltimore Washington Medical Center — named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Workplace in the USA for 2021! As part of the acclaimed University of Maryland Medical System, our facility is one of three ANCC Pathway to Excellence® designated hospitals in Maryland. UM BWMC features one of the state’s busiest emergency departments, as well as a team of experts who care for our community and one another. The University of Maryland Baltimore Washington Medical Center (UMBWMC) provides the highest quality health care services to the communities we serve. Our medical center is home to leading-edge technology, nationally recognized quality, personalized service and outstanding people. We have 285 licensed beds and we’re home to 3,200 employees and over 800 physicians. Our expert physicians and experienced, compassionate staff are connected to medical practices in the local community as well as at University of Maryland Medical Center in downtown Baltimore. For patients, this means access to high-quality care and research discoveries aimed at improving Maryland’s health. Our physicians and nursing staff specialize in emergency, acute, medical-surgical and critical care. In addition, our medical center is home to many Centers of Excellence, offering expert outpatient health care.

Education: Graduation from an accredited nursing education program approved by the Board of Nursing or found to be substantially equivalent to the programs in Maryland. Currently licensed as a Registered Nurse in the State of Maryland required, BSN preferred.

Experience: Three (3) years of relevant clinical experience required (Medical Surgical). Ongoing education, certification, and self-development to remain current with industry standards and business objectives related to hospital utilization and case management.

All your information will be kept confidential according to EEO guidelines.