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Utilization Review Nurse

State Of Maryland


Job Location:

Baltimore County, MD - USA

Yearly Salary: $ 87253 - 137603
Posted: 7 August 2026 (30 days ago)
Application Deadline: 4 November 2026
Vacancies: 1 Vacancy

Job Summary

GRADE
20
LOCATION OF POSITION
MDH Maryland Healthcare System 55 Wade Ave Catonsville MD
Main Purpose of Job
This position is responsible for conducting reviews on admissions continued stays and readmissions as well as managing the denial process. This position is vital to addressing the Maryland Department of Health (MDH) waitlist by identifying patients who no longer meet medical necessity criteria for inpatient care. These reviews are conducted independently of treatment teams to provide objective feedback to hospitals regarding patient position also manages the appeal process working with the Physician Advisor when patients do not meet medical necessity criteria. Cases are presented to the Utilization Review to recommend the committee to determine if a second Physician Advisor review is is a hybrid position that allows for position provides reports that identify opportunities to improve care through medical record reviews. These improvements may include the adequacy of documentation regarding patient progress missing or insufficient records the absence of required assessments and the overall quality of treatment.
MINIMUM QUALIFICATIONS

Education: Determined by the Maryland State Board of Nursing under the licensing requirements for Registered Nurses.

Experience: None.

DESIRED OR PREFERRED QUALIFICATIONS
The desired candidate should possess the following:
  • Experience using Google Suites (especially Google Sheets) to complete NRI statistics and maintain utilization review files and the UR database
  • Experience in Risk Management
LICENSES REGISTRATIONS AND CERTIFICATIONS

1. Candidates for positions in this classification must possess a current license as a Registered Nurse from the Maryland State Board of Nursing 4140 Patterson Avenue Baltimore Maryland 21215 or possess a current multi-state license in party states that candidates have declared as primary states of residence.

2. Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operators license valid in the State of Maryland.

3. Employees in this classification may be required to successfully complete and maintain current certification of cardiopulmonary resuscitation training.

SPECIAL REQUIREMENTS

1. Employees in this classification are subject to call-in and therefore will be required to provide the facility with a phone number at which they can be reached.

2. Employees in this classification are subject to substance abuse testing in accordance with Code of Maryland Regulations 17.04.09 Testing for Illegal Use of Drugs.

SELECTION PROCESS

Applicants who meet the minimum (and selective) qualifications will be included in further evaluation. The evaluation may be a rating of your application based on your education training and experience as they relate to the requirements of the it is essential that you provide complete and accurate information on your report all related education experience dates and hours of indicate your college degree and major on your application if applicable. For education obtained outside the U.S. any job offer will be contingent on the candidate providing an evaluation for equivalency by a foreign credential evaluation service prior to starting employment (and may be requested prior to interview).

Complete applications must be submitted by the closing submitted after this date will not be added.

Incorrect application forms will not be will not be accepted in lieu of a completed application.

Candidates may remain on thecertified eligible list for a period of at least one year. The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.

BENEFITS
FURTHER INSTRUCTIONS

Online applications are highly recommended. However if you are unable to apply onlinethe paper application (and supplemental questionnaire) may be submitted to MDH Recruitment and Selection Division 201 W. Preston St. Room 114-B Baltimore MD application materials must be received by 5 pm close of business on the closing date for the recruitment no postmarks will be accepted.

If additional information is required the preferred method is to upload. If you are unable to upload please fax the requested informationto .Only additional materials that are required will be accepted for this recruitment. All additional information must be received by the closing date and time.

For questions regarding this recruitment please contact theMDH Recruitment and Selection Division at .

If you are having difficulty with your user account or have general questions about the online application system please contact the MD Department of Budget and Management Recruitment and Examination Division at or.

Appropriate accommodations for individuals with disabilities are available upon request by calling: or MD TTY Relay Service 1-.

We thank our Veterans for their service to our country.

People with disabilities and bilingual candidates are encouraged to apply.

As an equal opportunity employer Maryland is committed to recruitment retaining and promoting employees who are reflective of the States diversity.


Required Experience:

IC


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