RN Utilization Management
Company: MedStar Health
Location: Fairfax
Posted on: February 26, 2026
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Job Description:
MedStar Health is seeking a dedicated RN Utilization Management
to join our not-for-profit healthcare team. This role is pivotal in
ensuring that all patient care provided meets the required
standards of efficiency, effectiveness, and quality. The position
demands a meticulous approach to monitoring and evaluating
healthcare services to optimize both patient outcomes and resource
utilization. Ideal candidates will share our patient-first
philosophy and commit to improving healthcare delivery within the
D.C.-Maryland-Virginia region. Evaluate patient care for
appropriateness and efficiency based on established criteria and
guidelines. Collaborate with healthcare providers to coordinate
patient care and optimize the use of resources. Review patient
records and treatment plans to ensure compliance with healthcare
regulations and standards. Discuss necessary changes in care with
healthcare teams and insurance providers. Stay informed on the
latest healthcare practices and regulations. Prepare and present
reports on patient outcomes and resource utilization to healthcare
management. Strong analytical and decision-making skills Excellent
interpersonal and communication skills Proficient in medical
software and healthcare databases In-depth knowledge of healthcare
regulations and insurance policies Medical Insurance Dental
Insurance Vision Insurance Life Insurance 401k Valid RN license
Certification in Case Management or Utilization Review preferred
but not required.
Keywords: MedStar Health, Baltimore , RN Utilization Management, Healthcare , Fairfax, Maryland
