Utilization Review Nurse RN in Baltimore, Maryland at LifeBridge Health

Who We Are:
LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to “improve the health of people in the communities we serve.” Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.

About the Role/Unit:
The Utilization Review RN at Sinai Hospital works with stakeholders in the Revenue Cycle Management process and payors to ensure efficiency of utilization of resources, minimize losses and maximize reimbursement.

Key Responsibilities:

• Medical necessity review of patient stays and referral to the physician advisor as needed
• Denial Management, including coordination with Case Management
• Monitor utilization of hospital resources

Requirements:

• Education: BSN preferred; ADN required
• Licensure: Registered Nurse License - Current Maryland license or Compact Multistate License
• Experience: At least 2 years of experience in acute inpatient utilization review required