Registered Nurse – Utilization Review

Ascension

. Review admissions and service requests to ensure every patient receives the right level of medical necessity at the right time .

Posted 11/3/2026full-timeRemote • Maryland • United StatesMid-LevelSenior💰 $73,008 - $139,127 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Utilization Management and Case Management, ensuring compliance with federal and payer regulations while effectively guiding patient journeys and resolving documentation hurdles.

Highest-signal resume keywords

Registered Nurse CredentialUtilization ManagementCase ManagementClinical Documentation ImprovementCompliance with Federal Regulations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Patient CareDocumentation ReviewReimbursement ResolutionDischarge PlanningMedical Necessity Assessment

Soft Skills

CollaborationProblem-SolvingCommunication

Certifications & Qualifications

Maryland Board of Nursing Credential

Industry Keywords

HealthcarePatient JourneyService RequestsFederal RegulationsPayer Regulations

About the role

Key responsibilities & impact

Review admissions and service requests to ensure every patient receives the right level of medical necessity at the right time
Guide complex patient journeys through case management and consultation
Resolve documentation and reimbursement hurdles for the frontline care team
Collaborate with the healthcare team to build safe, effective discharge plans
Oversee compliance with federal and payer regulations

Requirements

What you’ll need

Registered Nurse credentialed from the Maryland Board of Nursing obtained prior to hire date or job transfer date required
Diploma from an accredited school/college of nursing OR required professional licensure at time of hire
Proven experience in Utilization Management, Case Management, or Clinical Documentation Improvement within a healthcare setting is preferred
Monday-Friday 8:00AM-4:30PM
Weekend rotation once per month
Employer does not participate in E-Verify and therefore cannot employ STEM OPT candidates

Benefits

Comp & perks

Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options
Employer-matched 403(b)
Planning and hardship resources
Disability and life insurance
Pro-rated paid time off (PTO) and holidays
Ascension-paid tuition (Vocare)
Tuition reimbursement
Ongoing professional development and online learning
Employee Assistance Program
Counseling and peer support
Spiritual care and stress management resources
Parental leave
Adoption assistance and family benefits
Optional legal and pet insurance
Transportation savings