Senior Review Coordinator



About Us

Absolute Staffing & Consulting Solutions is a woman, minority, and veteran-owned business based in Westminster, Maryland. As a trusted subcontractor, we specialize in staff augmentation for IT, allied health, customer support, administrative roles, and more, serving private businesses and government entities at all levels.

About the Client

Our client is a nationally recognized healthcare quality improvement organization dedicated to helping individuals live healthier lives by improving healthcare outcomes across the United States. For more than 50 years, the organization has partnered with health plans, federal programs, and state agencies to deliver proven healthcare solutions that improve the quality of care while reducing costs.

Position Summary

The Senior Review Coordinator is responsible for performing utilization review and medical management activities, including prospective, concurrent, and retrospective review for Long Term Care and Hospice services. This role ensures that care services meet clinical guidelines, regulatory standards, and contractual requirements while supporting high-quality patient outcomes.

Essential Functions

• Perform utilization review of plans of service for home and community-based programs
• Review complex plans of service and serve as a resource for non-clinical reviewers
• Provide independent review decisions for behavioral health services and evaluate the appropriateness and quality of care based on contract, state, or URAC requirements
• Screen cases using established criteria to determine whether care services are appropriate
• Refer cases that do not meet criteria to peer reviewers for further evaluation
• Ensure reviews are conducted thoroughly and within required timeframes
• Serve as a liaison between peer reviewers, providers, facilities, and subscribers
• Document medical information and review decisions in the workflow documentation system, ensuring accuracy and timely entry

Required Qualifications

• Compact RN License in Maryland
• 3–5 years of recent clinical experience
• Long Term Care experience
• Strong written and verbal communication skills
• Strong typing and data entry skills
• Comfortable working with multiple systems and multi-monitor environments
• Ability to maintain regular and predictable attendance due to the time-sensitive nature of the work

Preferred Qualifications

• Prior Utilization Management (UM) experience
• Knowledge of medical coding and billing
• Hospice care experience

Working Conditions

• Remote
• Monday- Friday, 8:00-5:00 EST
• Six-month contract position with the possibility of extension

Pay Rate

• $40.00 - $42.00 hourly based on experience