The Utilization Review Nurse RN performs medical necessity reviews, monitors hospital resource utilization, and coordinates denial management in collaboration with case management and physician advisors. This PRN position focuses on maximizing reimbursement and ensuring efficient use of healthcare resources within an acute inpatient setting. Candidates require an active nursing license, acute utilization review experience, and preferably behavioral health background.
Utilization Review Nurse RN - PRNApply Now Save Job Saved
Summary
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 PRN 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:
Requirements:
Must Live in One of the Following Districts/States: District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia
Additional Information
What We Offer: Impact: Join a team that values innovation and outcomes, delivering life-saving care to our youngest and most vulnerable patients. Growth : Opportunities for professional development, including tuition reimbursement and developing foundational skills for neonatal critical care leadership and advanced certification. Support: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support — improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license. Benefits : Competitive compensation (additional compensation such as overtime, shift differentials, premium pay, and bonuses may apply depending on job), comprehensive health plans, free parking, and wellness programs. Why LifeBridge Health? With over 14,000 employees, 130 care locations, and two million annual patient encounters, we combine strategic growth, innovation, and deep community commitment to deliver exceptional care anchored by five leading centers in the Baltimore region: Sinai Hospital of Baltimore, Grace Medical Center, Northwest Hospital, Carroll Hospital, and Levindale Hebrew Geriatric Center and Hospital. Our organization thrives on a culture of CARE BRAVELY—where compassion, courage, and urgency drive every decision, empowering teams to shape the future of healthcare. LifeBridge Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression. LifeBridge Health does not exclude people or treat them differently because of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression.Share:
Apply Now
Utilization Review Nurse, Registered Nurse, Medical Necessity Review, Denial Management, Revenue Cycle Management, Acute Care Nursing, Behavioral Health Nursing, Hospital Resource Utilization, Healthcare Reimbursement, Patient Care
...Title Examiner - do not apply if you cannot be in the office full time locally. This job is NOT remote friendly- do not apply if you cannot be in the Oak Forest, IL office full time. ONLY QUALIFIED candidates will be considered. We are seeking a dedicated title...
...Cooperidge Consulting Firm is seeking a Safety Critical Software Engineer Lead to join a high-impact engineering team. In this role, you will drive the design and delivery of robust, compliant, and reliable safety-critical software systems. The position involves hands...
...Understands Agile and relevant frameworks (e.g., scrum) to maximize the success of the squad.... ...the squad to provide input for squad level decision making to achieve a common goal.... ...: Bachelor's degree preferred with Masters or equivalent experience Minimum of 4...
...Job Description Rang Healthcare is seeking a travel Pharmacy Technician for a travel job in Lincoln City, Oregon. Job Description &... ...pharmacy technicians who are dedicated to patient care. EXPERIENCE/EDUCATION/QUALIFICATIONS Current unencumbered Certified...
...Associate Creative Director Headway's mission is to build a new mental health care system everyone can access. We've built technology that helps people find great therapists with the first software-enabled national network of providers accepting insurance. One in...