RNUtilization ManagementCase ManagementNurse TriageIntellectual and Developmental Disabilities
Posted Jul 28, 2026 · Last seen active Jul 29, 2026
About this role
The multi-state Registered Nurse (RN), currently licensed and in good standing in the District of Columbia, Maryland, and Virginia, provides clinical and operational oversight for prior authorization and level-of-care determinations related to non-emergency transportation services. The RN is responsible for evaluating and investigating prior authorization requests to ensure appropriate medical necessity and determining the most suitable mode of transportation based on beneficiary needs. This role also serves as a critical clinical decision-maker for a nurse triage line, receiving transfers from local emergency services for individuals experiencing non-emergency medical conditions. The RN assesses these cases in real time and appropriately routes beneficiaries to the nearest available non-emergency medical care setting, helping to reduce unnecessary emergency department utilization and improving care coordination.
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In collaboration with the Department of Disability Services and other stakeholders, the RN manages Intellectual and Developmental Disabilities (IDD) requests, oversees the Level of Need (LON) process, and ensures accurate determination of appropriate transportation resources. The position also supports the development and facilitation of education and training programs for transportation providers and contractor staff.
Requirements
Registered Nurse with multi-state license to include Washington DC, Maryland and Virginia
Medicaid insurance guidelines knowledge
Strong clinical judgment and chart review skills
Comfort with utilization of review software and documentation systems
Excellent written and verbal communication skills
Strong analytical skills and attention to detail
Excellent time management skills
Self-motivated/self-starter, can work independently
Living in Washington, DC
Washington, DC blends monumental grandeur with livable neighborhood charm. From the historic rowhouses of Capitol Hill to the wooded trails of Rock Creek Park, the nation's capital offers renowned hospital systems, free Smithsonian museums, and Metro access that connects the city to surrounding suburbs.
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