Oversees utilization review/management daily operations and workflow. Serves as a clinical resource and lends guidance to the Utilization Review staff in concurrent and retrospective review, resource utilization and denials and appeals management.

Requirements: Formal working knowledge; equivalent to an Associate's degree (2 years college); requires knowledge of a specialized field.  Maryland Registered Nurse License, CPR Certification; Microsoft Office Suite, Basic computer skills, Cerner, Synquest, Standard Office Equipment, Medical terminology, Nursing Process skills based on MD Nurse Practice Act, Critical thinking skills, Interqual and Milliman Utilization Review Criteria.  Three to five years of experience.