Job Information

Corizon Health Utilization Management (UM) Nurse Coordinator in Hanover, Maryland

About Corizon Health

Correctional healthcare is not just a job. It’s a calling.

By choosing a career with Corizon Health, you are choosing the opportunity to truly make a difference in the health, well-being, and future of the patients you serve. We take pride in being a pioneer provider of correctional healthcare. As a Corizon Health professional, you have access to the resources and support to enhance your skills, build a solid foundation to reach your career potential, and contribute to the care and well-being of an underserved population. There is no greater calling. Join Corizon Health today and be part of our legacy of innovation and clinical expertise.

Responsibilities

Below is a list of your responsibilities as a Utilization Management (UM) Nurse Coordinator with Corizon Health at our Maryland Regional Office located in Hanover, Maryland:

Inpatient Duties

  • Review, compile and coordinate the data required for UM Monthly Reports to include inpatient, outpatient, ER and CARES files.

  • Complete daily clinical documentation in the EPHR with updates on inpatient discharges.

  • Upload hospital/patient clinical documentation into the EPHR.

  • Facilitates the timely discharge of hospitalized patients to their designated site or the infirmary.

  • Collaborates with the hospitalists, Corporate UM and Statewide Medical Director for notices of non-coverage/appeals for inpatient stays.

  • Maintain CARES documentation to include SOAP notes, InterQual Review with the addition of bed days.

  • Assist in the completion of special projects and the orientation of new UM staff on an as needed basis within the Department.

  • Reviews all requests for outpatient/onsite specialty services and obtains required clinical rationale.

  • Collaborates with Corporate to resolve vendor claim issues and customer service calls.

  • Covers in the absence of the inpatient nurse for documentation an follow up.

  • Conduct collaborative meetings with UM schedulers to assist with UM process improvement.

  • Assist in the completion of special projects and the orientation of new UM staff on an as needed basis within the Department.

Experience & Requirements

  • Registered Nurse within the State of Maryland.

  • Bachelor’s degree preferred.

  • Broad clinical knowledge with good communication skills/clinical background, analytical and decision making skills, clinical data collection and report documentation.

  • Experience in working with InterQual, Utilization Management, discharge planning, chart review and Case Management a plus.

  • Knowledge of health care delivery system in correctional setting, preferred.

  • Current CPR certification.

  • Proficiency in reading, writing and speaking English.

A background check, security clearance and drug screening are required for this role.

Corizon Health is an Equal Opportunity/Affirmative Action Employer. In compliance with federal and state employment opportunity laws, qualified applicants are considered for all positions without regard to race, gender, national origin, religion, age, sexual orientation, disability, Vietnam era veteran, or disabled Veteran status. EOE including Disability/Protected Veterans .

Not ready to apply? Connect with us for general consideration.

ID 2020-8354

Job Locations US-MD-Hanover

Category Nursing & Nursing Assistant

Position Type Regular Full-time

Shift / Schedule Weekday Day

Location ID 91200