LH
Annapolis, Maryland, United States
$34 – $55/hr
LH
Active2mo ago
Utilization Management Denials Nurse
Role overview
Job description
Position Objective: Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment. Essential Job Duties: 1. Chart Review : Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with external reviews, care coordinators, and providers; reconciles and records days authorized in EPIC 2. Denial Management : Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken to avoid denial; assists Care Coordinator in communicating with the patient denied hospital days with work toward re
…About this listing
- Source: Luminis Health's official careers site (via Greenhouse) · last confirmed on the source 29 Oct 2026
- Posted 25 Aug 2026
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What they are looking for
Skills & requirements
Qualification
Educational/Experience Requirements: Bachelor’s of Science in Nursing or Associate’s degree in Nursing with equivalent experience; Required License/Certifications: Current RN license from Maryland Board of Nursing
Department · Luminis Health - LH Utilization Management
Hiring company
Luminis Health
Healthcare
Luminis Health is a nationally recognized health system in Maryland. With more than 700 inpatient beds and nearly 100 sites of care across the region, including Anne Arundel Medical Center, Doctors Community Medical Center, J. Kent McNew Family Medical Center, Pathways, and Luminis Health Clinical Enterprise, we are committed to providing easy access to high-quality care, near to where people, live, work and play. Luminis Health believes that health and wellness are fundamental to everyone and by working side by side with our community, patients, and partners, we generate a positive impact for all. We are committed to diversity and addressing health equity. We believe access to healthcare should be refreshingly easy. Our R.I.S.E. values of Respect, Inclusion, Service, and Excellence guide how we work together every day. We will enhance the health of the people and communities we serve, because we believe that we're better together. All of us.
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