Utilization & Review Care Manager, FT Days - Care Management

Rockville, MD
Jul 11, 2019
Oct 01, 2019
Full Time
As a faith-based organization, with over a century of caring for the communities in the Maryland area, Adventist HealthCare has earned a reputation for high quality, compassionate care. Adventist HealthCare was the first and is the largest healthcare provider in Montgomery County.

Adventist HealthCare seeks to hire a Utilization & Review Care manager who will embrace our mission to extend God's care through the ministry of physical, mental and spiritual healing. If you want to make a difference in someone's life every day, consider a position with a team of professionals who are doing just that, making a difference.

Qualified candidates will possess:
Bachelor's degree in nursing, social work, psychology, or any related psychology or behavioral health degree. Master's preferred
College level reading, writing and math with strong verbal skills
Basic PC skills (MS word, Excel and Access)
Understanding of managed care and ability to apply and interpret behavioral health care service delivery
Knowledge of medication and medical terminology
Strong customer service skills
Able to handle a multi-task environment and work independently with some supervision.

The Utilization & Review Care Manager:
Is Responsible for reviewing medical records for clinical criteria, appropriate level of care and compliance with standards.
Assures compliance with standards; ie. JCAHO, COMAR, HIPAA, Federal and State Regulations.
Conducts pre-authorization as needed; performs concurrent and continued stay reviews.
Obtains authorization for all related services; ie. psychological, medical, chemical dependency and other levels of care.
Prepares and submits medical record for appeal.
Assists the treatment team with information related to discharge planning and obtains authorization as needed.
Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients.

Work Schedule:

Day shift

At Adventist HealthCare our job is to care for you. We do this by offering:
  • Work life balance through non rotating shifts
  • Recognition and rewards for professional expertise
  • Free Employee parking
  • Competitive comprehensive benefit plans offered (including health, disability, PTO and 403B retirement plan with matching and 3 year vesting)
  • 100% Coverage for inpatient care - at Adventist HealthCare facilities
  • 100% Coverage for urgent care nationwide - after copay

Join the Adventist Healthcare team today! Apply now to be considered.

Tobacco Statement

Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine use.

Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine). Those testing positive for cotinine are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing.

Equal Employment Opportunity

Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

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