Concurrent Review Manager
4 weeks ago
Summary:
This position is responsible for the planning, development, organization and evaluation of functions for concurrent review programs. Concurrent review is one of the processes within medical management to evaluate while a member is hospitalized the medical necessity of the admission and the appropriateness of the services provided. The process is intended to reduce occurrences of over-under- or misuse of services to improve the member’s inpatient care outcomes and to ensure the cost-effectiveness of the services.
About Maryland Care Management, Inc. (MCMI)
Maryland Care Management, Inc. (MCMI) manages Maryland Physician Care's (MPC) statewide provider network of hospitals and physicians. Maryland Physicians Care has been providing services to the HealthChoice Medicaid populations since 1996, and we are proud of our footprint in the community. With over 230,000 members, MPC consistently has been one of MD's largest Medicaid-managed care organizations.
Why join us?
MCMI recognizes the importance of flexibility and offers multiple work arrangements. Along with competitive pay, we offer excellent benefits (medical, dental, and vision plans, 100% employer Term Life Insurance, Short and Long-Term Disability, 401k Employer Match up to 4%) as well as 20 days of PTO, and tuition assistance/professional development plans.
Your future colleagues at MCMI are welcoming, friendly, and eager to help each other succeed. We are committed to Diversity, Equity, and Inclusion, providing organizational-wide social opportunities, and constantly improving our ongoing efforts to positively impact our members' lives.
What You’ll Do:
- Recruit and select appropriate staff[VH1] and prepare timely employee performance evaluations.
- Provide oversight of the concurrent review process.
- Promote individual and team development.
- Prepare reports of utilization indicators and activities for committees and senior management.
- Collaborate with the Director of UM on the development of annual budget.
- Collaborate with interdisciplinary teams and Providers to support staff in coordination of discharge planning and care activities.
- Serve as an active participant in clinical committees.
- Assist in the annual development of measurable goals for inpatient utilization review programs.
- Oversee Skilled Nursing Facility disenrollment process.
Secondary Functions:
- Promote improved customer service to staff and recognize their improvement efforts.
- Responsible for the development, implementation, and annual review of concurrent review policies and desktops.
Knowledge and Skills:
- Demonstrated skills for presentations and training before small and large groups.
- Knowledge of local health care delivery system.
- Proven Microsoft Office Experience
- Current state RN license
- Bachelor of Science in Nursing or Health Care Administration and/or health-related field (BSN preferred).
- Master’s or MBA preferred.
- Three to five years of progressively responsible healthcare administrative experience in a managed care setting.
- Minimum of two years of management and supervisory experience.
- Minimum of three years of clinical UM experience.
EEOC Statement:
Following applicable federal, state, and local laws, MCMI prohibits discrimination in employment based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, or any other characteristic protected by law. This commitment extends to all aspects of employment, including hiring, promotion, compensation, benefits, training, social and recreational programs, and all other conditions and privileges of employment.
As a healthcare organization, we recognize the vital importance of inclusivity in delivering quality care to our patients. We strive to foster an environment where individuals of all backgrounds feel respected, valued, and supported. We aim to better comprehend the unique needs of our patients and provide healthcare services that are culturally competent and sensitive.
We encourage candidates from all backgrounds to apply and join us in our mission to provide compassionate and inclusive healthcare. We believe that a diverse workforce enriches our organization and allows us to better understand, connect with, and serve our diverse patient population.
-
Temporary Accounts Payable Specialist
2 months ago
Linthicum Heights, United States Absolute Staffing & Consulting Solutions Full timeJob DescriptionJob DescriptionAbsolute Staffing is searching for two temporary Accounts Payable Specialist's to work with our client. Location: Remote with limited travel to Linthicum Heights, MDTravel Required: Limited, local travelPosition Type: TemporaryPosition SummaryThe Temporary Accounts Payable (A/P) Specialist ensures the timely and accurate...
-
Manager, Reimbursement Data Management
1 week ago
Linthicum Heights, United States University of Maryland Medical System Full timeJob DescriptionJob DescriptionCompany DescriptionThe University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of...
-
Manager, Reimbursement Data Management
1 month ago
Linthicum Heights, United States University of Maryland Medical System Full timeJob DescriptionJob DescriptionCompany DescriptionThe University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of...
-
Clinical Staffing Account Manager
3 months ago
Linthicum Heights, United States University of Maryland Medical System Full timeJob Description General Summary Under general administrative direction, the Clinical Account Manager oversees the placement of staff to UMMS member organizations (customers) by fostering positive relationships with both clinicians and customers. This role is accountable for the assignment of staff to provide patient care which supports the...
-
Project Management Office Coordinator
1 week ago
Linthicum Heights, Maryland, United States Two95 International Inc. Full timePosition Title: Project Management Office Coordinator (Scrum Master)Employment Type: Contractual EngagementCompensation: Competitive RateKey Responsibilities:1. Organize and facilitate meetings, document minutes, track action items, and manage multiple tasks concurrently.2. Utilize Microsoft Office Suite to produce well-structured reports and...
-
Account Manager
3 months ago
Linthicum Heights, United States York Telecom Corporation Full timeJob DescriptionJob DescriptionFor over 35 years, Yorktel has been the video managed services partner around the world for some of the largest business and government agencies. With over 10,000 video systems under management worldwide – more than any other video communications service provider – Yorktel has the proven expertise and global reach to deliver...
-
Risk Manager
3 months ago
Linthicum Heights, United States Maryland Physicians Care Full timeJob Type Full-time Description Summary: The Risk Manager, directly reporting to the Chief Compliance and Government Relations Officer (CCO) plays a critical role in identifying, assessing, and mitigating risks across the organization. This position maintains, improves, and implements a comprehensive enterprise risk management framework approved by the...
-
Risk Manager
3 months ago
Linthicum Heights, United States Maryland Physicians Care Full timeJob Type Full-time Description Summary: The Risk Manager, directly reporting to the Chief Compliance and Government Relations Officer (CCO) plays a critical role in identifying, assessing, and mitigating risks across the organization. This position maintains, improves, and implements a comprehensive enterprise risk management framework approved by the...
-
Assistant General Manager
1 month ago
Linthicum, United States SpringHill Suites Baltimore BWI Airport Full timeAs Assistant General Manager you will mentor our ambitious TEAM ensuring outstanding guest service and delivering positive guest experiences. In this role you will collaborate with our General Manager to plan and oversee the hotel’s daily operations, and assume responsibilities in their absence.TEAM Culture:Our TEAM culture motivates and encourages each...
-
Risk Manager
4 weeks ago
Linthicum Heights, United States Maryland Care Management, Inc Full timeJob DescriptionJob DescriptionDescription:Summary:The Risk Manager, directly reporting to the Chief Compliance and Government Relations Officer (CCO) plays a critical role in identifying, assessing, and mitigating risks across the organization. This position maintains, improves, and implements a comprehensive enterprise risk management framework approved by...
-
Compensation Processing Specialist
1 week ago
Linthicum Heights, Maryland, United States Absolute Staffing & Consulting Solutions Full timeJob OverviewAbsolute Staffing & Consulting Solutions is seeking a Payroll Specialist for our esteemed client.**Candidates must reside within a one-hour commute of Linthicum Heights, MD**Job Classification: Non-ExemptWork Arrangement: Remote; occasional travel for quarterly meetings and training sessionsEmployment Type: Full-TimeCompensation: $23/hourRole...
-
Compensation Analyst
1 week ago
Linthicum Heights, Maryland, United States Absolute Staffing & Consulting Solutions Full timeJob OverviewAbsolute Staffing & Consulting Solutions is seeking a Payroll Specialist for a key role within our organization.**Candidates must reside within a one-hour commute of Linthicum Heights, MD**Job Classification: Non-ExemptWork Arrangement: Remote; occasional travel for quarterly meetings and training sessionsEmployment Type: Full-TimeCompensation:...
-
Compensation Analyst
1 week ago
Linthicum Heights, Maryland, United States Absolute Staffing & Consulting Solutions Full timeJob OverviewAbsolute Staffing & Consulting Solutions is seeking a Payroll Specialist for a valued client.**Candidates must reside within a one-hour commute of Linthicum Heights, MD**Job Classification: Non-ExemptWork Arrangement: Remote; occasional travel for quarterly meetings and training in Linthicum Heights, MDEmployment Type: Full-TimeCompensation:...
-
Pricing and Estimation Manager
6 days ago
Linthicum Heights, Maryland, United States Northrop Grumman Full timeRequisition ID: R Category: Business Management Location: Linthicum, Maryland, United States of America Clearance Type:Secret Telecommute: Yes-May consider hybrid teleworking for this position Shift: 1st Shift (United States of America)Travel Required: Yes, 10% of the Time Positions Available: 1At Northrop Grumman, our employees have incredible opportunities...
-
Compensation Processing Specialist
1 week ago
Linthicum Heights, Maryland, United States Absolute Staffing & Consulting Solutions Full timeJob OverviewAbsolute Staffing & Consulting Solutions is seeking a Compensation Processing Specialist for our esteemed client.**Candidates must reside within a reasonable commuting distance.**Job Category: Non-ExemptManager: Payroll ManagerLocation: RemoteTravel Requirements: Occasional travel for meetings and training sessionsEmployment Type:...
-
Linthicum Heights, Maryland, United States Northrop Grumman Full timeAbout the RoleWe are seeking a highly skilled Hardware Configuration Management Specialist to join our team at Northrop Grumman. As a key member of our Configuration Management team, you will play a critical role in ensuring the successful execution of our projects.Key ResponsibilitiesPlan and coordinate the preparation of project documentation, including...
-
Compensation and Benefits Coordinator
1 week ago
Linthicum Heights, Maryland, United States Absolute Staffing & Consulting Solutions Full timeJob OverviewAbsolute Staffing & Consulting Solutions is seeking a Compensation and Benefits Coordinator for our client.**Candidates must reside within a reasonable commuting distance.**Job Category: Non-ExemptLocation: Remote; occasional travel for meetings and training may be required.Position Type: Full-TimeCompensation: $23/hourPosition...
-
Manager, Coding Operations
1 day ago
Linthicum Heights, United States University of Maryland Medical System Full timeJob DescriptionJob DescriptionCompany DescriptionRenowned as the academic flagship of the University of Maryland Medical System, our Magnet®-designated facility is a nationally recognized, academic medical center with opportunities across the continuum of care. Come join UMMC and discover the atmosphere where talents and ideas come together to enhance...
-
Payroll Specialist
1 month ago
Linthicum Heights, United States Absolute Staffing & Consulting Solutions Full timeJob DescriptionJob DescriptionAbsolute Staffing is searching for a Payroll Specialist on behalf of our client. **MUST live within 1 hour of Linthicum Heights, MD**Job Category: Non-ExemptLocation: Remote; limited travel to Linthicum Heights, MD for quarterly meetings & training Position Type: Full-TimePay rate: $23/hourPosition SummarySelf-Directed Services...
-
Payroll Specialist
1 month ago
Linthicum Heights, United States Absolute Staffing & Consulting Solutions Full timeJob DescriptionJob DescriptionAbsolute Staffing is searching for a Temporary Payroll Specialist to work with our client. **MUST live within 1 hour of Linthicum Heights, MD**Location: Remote; limited travel to Linthicum Heights, MD for quarterly meetings & training Position Type: Temporary 3-6 months Pay Rate: $23/Hour Position SummarySelf-Directed Services...
