Utilization Review Nurse RN

Utilization Review Nurse RN Internal Only 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 Must Live in One of the Following Districts/States: District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia Benefits Competitive compensation, including overtime, shift differentials, premium pay, and bonuses (may apply depending on job) Comprehensive health plans, free parking, and wellness programs Professional development opportunities, including tuition reimbursement and foundational skills for neonatal critical care leadership and advanced certification Culture of collaboration with unit‑based practice councils and advanced clinical education support Equal Employment Opportunity Statement 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. #J-18808-Ljbffr