Utilization Management Specialist

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Make it happen at Hopkins!

Johns Hopkins Bayview is a vibrant academic medical center, offering services that range from primary care and emergency medicine, to specialized centers for burn treatment, bariatric surgery, pelvic health, allergy and asthma, and Alzheimer's Disease. Our staff provides compassionate healthcare focused on the uniqueness and dignity of each person we serve.

Click or copy and paste this link to our video to learn about our amazing legacy!

https://www.youtube.com/watch?v=of06sf9kiHk

What you will do:

The UM Specialist performs Utilization Management activities which includes admission review, concurrent review, retrospective chart review and clinical systems review to measure clinical performance and Utilization Management issues that affect reimbursement for the patient's hospital stay or visit. Conducts medical record review; provides clinical information to the payer; collects and reports Utilization Management data; interacts with clinical team, Physician Advisor; and engages in special projects.

What awaits you:

In addition to working with some of the best and brightest in the medical field, we offer our employees generous benefits, incentives and numerous career options. You can enjoy an environment that is continually recognized as one of the best workplaces in the world.

• Career growth
• Comprehensive medical, dental, and vision insurance
• Flexible Spending Accounts (FSA)
• Prescription Drugs
• Life and Disability Insurance
• Employee tuition assistant
• Dependent tuition reimbursement
• 403B with Employee matching
• PTO
• Child Care (2 - 5 years old)
• Stay healthy at Healthy@Hopkins Program
• For more information regarding benefits, visit or click: Johns Hopkins Bayview Medical Center | Your benefits virtually (mybenefitsjhhs.com)

What you will bring:

• Completion of an accredited Nursing Program (RN) or LCSW required, BSN preferred.
• Minimum of five years of nursing experience or five years of licensed social work experience, with preference for Utilization Management, Care Management, Appeals and/or clinical experience, with preference for MCG knowledge and experience.
• Current and unrestricted Maryland or compact RN license or Social Work License for Psychiatry required.

Salary Range: Minimum 42.34/hour - Maximum 65.62/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.