LifeBridge Health Is Hiring An UTILIZATION REVIEW NURSE

Summary

Join our team as a Utilization Review Nurse - Psych RN Experience and play a vital role in ensuring efficient patient care through chart reviews, denial management, and care coordination. 🩺

Position Summary

Conducts concurrent and retrospective chart reviews to analyze clinical, financial, and resource utilization data. Provides strategic intervention and coordination efforts to minimize avoidable delays and prevent payment denials.

Essential Functions

• Chart Review

  Reviews medical records by applying utilization review criteria to evaluate clinical, financial, and resource consumption.

• Denial Management

  Monitors and identifies patterns or trends in utilization management to proactively address potential denials.

• Care Coordination

  Collaborates with Care Managers to achieve optimal patient outcomes, reduce length of stay, and prevent delays and denied days.

Qualifications & Requirements

Education & Knowledge

• Basic professional knowledge, comparable to a Bachelor's degree
• Knowledge of theory and practice within a specialized nursing field
• Minimum education: Bachelor of Science in Nursing

Experience

• 3-5 years of relevant experience, specifically in Psych Nursing
• Strong critical thinking skills
• Ability to perform efficient clinical/chart reviews and information abstraction

Certifications, Licenses & Registrations

• Maryland Registered Nurse License
• American Heart Association BLS Certification

Additional Information

As one of Maryland’s leading healthcare providers with over 13,000 team members, we are committed to CARE BRAVELY for more than 1 million patients annually. Our organization includes Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital, Grace Medical Center, along with community-based services such as the Center for Hope, Practice Dynamics, and trusted partners like LifeBridge Health & Fitness, ExpressCare, and HomeCare of Maryland. 🏥🤝