UTILIZATION REVIEW NURSE

4 weeks ago

Baltimore MD, United States LifeBridge Health Full time
UTILIZATION REVIEW NURSE - PRN
  • Baltimore, MD
  • SINAI HOSPITAL
  • UTILIZATION REVIEW
  • PRN - Weekends - Day shift - 8:00am-4:30pm
  • RN Other
  • 83284
  • Posted: Yesterday
Apply Now // Setting the Saved Jobs link function setsavedjobs(externalidlist) { if(typeof externalidlist == 'undefined') { var saved_jobs_query = '/jobs/search?'+externalidlist.replace(/\-\-/g,'&external_id[]=')+'&saved_jobs=1'; var saved_jobs_query_sub = saved_jobs_query.replace('/jobs/search?','').replace('&saved_jobs=1',''); if (saved_jobs_query_sub = '') { $('.saved_jobs_link').attr('href',saved_jobs_query); } else { $('.saved_jobs_link').attr('href','/pages/saved-jobs'); } } } var is_job_saved = 'false'; var job_saved_message; function savejob(jobid) { var job_item; if (is_job_saved == 'true') { is_job_saved = 'false'; job_item = ''; $('.saved-jobs-alert__check').toggleClass('removed'); $('.saved-jobs-alert__message').html('Job has been removed.'); } else { is_job_saved = 'true'; job_item = ''+'--'+jobid; $('.saved-jobs-alert__check').toggleClass('removed'); $('.saved-jobs-alert__message').html('Job has been saved'); } document.cookie = "c_jobs="+job_item+';expires=;path=/'; $('.button-saved, .button-save').toggleClass('d-none'); $('.button-saved').append(' '); $('.saved-jobs-alert-wrapper').fadeIn(); setTimeout(function() { $('.button-saved').html('Saved'); $('.saved-jobs-alert-wrapper').fadeOut(); }, 2000); // Setting the Saved Jobs link - function call setsavedjobs(job_item); } Save Job Saved

Summary

Position Summary: Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment.

Essential Functions - 

  • Chart Review Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource consumption.
  • Denial Management Monitors and identifies patterns or trends in utilization management.
  • Care Coordination Coordinates with the Care Manager to achieve optimal and efficient patient outcomes, while decreasing length of stay and avoid delays and denied days.

Qualifications/Requirements - 

Education/Knowledge:Basic professional knowledge; equivalent to a Bachelor's degree; working knowledge of theory and practice within a specialized field Education/Knowledge:

Education Discipline:

  • Minimal degree requirement: Bachelor of Science in Nursing. (BSN's from CCNE accredited schools)

Certification or Licenses:

  • Required Maryland Registered Nurse License

Experience:

  • Medical terminology (Frequently)
  • Nursing Process skills based on MD Nurse
  • Practice Act (Frequently)
  • Critical thinking skills (Frequently) Midas (Frequently)
  • Healthstream (Occasionally)
  • Utiization Review Criteria (Frequently)
  • Microsoft Office Suite (Frequently)
  • Basic computer skills (Frequently)
  • Cerner (Frequently)
  • Standard Office Equipment (Frequently)   

Additional Comments Work from home will be 95% or greater. Training/remediation may be onsite with occasional onsite meetings

Additional Information

As one of the largest health care providers in Maryland, with 13,000 team members, We strive to CARE BRAVELY for over 1 million patients annually. LifeBridge Health includes Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital and Grace Medical Center, as well as our Community Physician Enterprise, Center for Hope, Practice Dynamics, and business partners: LifeBridge Health & Fitness, ExpressCare and HomeCare of Maryland. Share: talemetry.share(); Apply Now var jobsmap = null; var jobsmap_id = "gmapatmcp"; var cslocations = $cs.parseJSON('[{\"id\":\"1830292\",\"title\":\"UTILIZATION REVIEW NURSE - PRN\",\"permalink\":\"utilization-review-nurse-prn\",\"geography\":{\"lat\":\"39.3527548\",\"lng\":\"-76.6619418\"},\"location_string\":\"2401 W. Belvedere Avenue, Baltimore, MD\"}]'); function tm_map_script_loaded(){ jobsmap = new csns.maps.jobs_map().draw_map(jobsmap_id, cslocations); } function tm_load_map_script(){ csns.maps.script.load( function(){ tm_map_script_loaded(); }); } $(document).ready(function(){ tm_load_map_script(); });

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Baltimore, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE Sign On Bonus Potential: $15,000 Baltimore, MD ...

  • UTILIZATION REVIEW NURSE

    3 weeks ago

    Baltimore, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE Sign On Bonus Potential: $15,000 Baltimore, MD ...

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Baltimore, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE - PRN Baltimore, MD ...

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Baltimore, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE - PRN Baltimore, MD ...

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Baltimore, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE (RN) - PRN Baltimore, MD ...

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Baltimore, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE (RN) - PRN Baltimore, MD ...

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Baltimore, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE (RN) - PRN Baltimore, MD ...

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Randallstown, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE (RN) Randallstown, MD ...

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Randallstown, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE (RN) Randallstown, MD ...

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Randallstown, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE (RN) Randallstown, MD ...

  • RN Utilization Review

    2 days ago

    Largo, MD, United States Kaiser Permanente Full time

    Job Summary: The Utilization Review RN is responsible for utilization review, discharge planning and transitions in care, in collaboration with MAPMG rounder in acute or alternative settings of care. Essential Responsibilities: Utilization Review. According to department policy, procedure and protocols, consistently apply and verbally...

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Baltimore, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE (RN) - PRNBaltimore, MDSINAI HOSPITALUTILIZATION REVIEWPRN - As Needed - 8:00am-4:30pmRN Other82413Posted:March 21, 2024Apply NowSave JobSavedSummaryPosition Summary:Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease...

  • Rn Utilization Review- Appeals Coordinator

    7 days ago

    Baltimore, United States MEDSTAR HEALTH Full time

    Reviews and evaluates external denials for medical necessity. Coordinates and monitors the preventive denial and appeals process. Collaborates with the physician, nurse manager, and other members of the health care team to meet individualized patient outcomes. Performs pre-admission, concurrent, and retrospective medical record reviews based on approved...

  • UTILIZATION REVIEW NURSE

    4 weeks ago

    Randallstown, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW NURSE (RN)Randallstown, MDNORTHWEST HOSPITALNW CARE MANAGEMENTFull-time - Day shift - 8:00am-4:30pmRN Other81988Posted:March 21, 2024Apply NowSave JobSavedSummaryPosition Summary:Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to...

  • UTILIZATION REVIEW

    4 weeks ago

    Baltimore, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW / CASE MANAGEMENT RN - Part Time, Weekends Baltimore, MD ...

  • UTILIZATION REVIEW

    3 weeks ago

    Baltimore, MD, United States LifeBridge Health Full time

    UTILIZATION REVIEW / CASE MANAGEMENT RN - Part Time, Weekends Baltimore, MD ...

  • Travel Nurse RN

    2 weeks ago

    Baltimore, MD, United States Health Advocates Network-Nursing Full time

    Health Advocates Network-Nursing is seeking a travel nurse RN Utilization Review for a travel nursing job in Baltimore, Maryland.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 06/17/2024Duration: 14 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelHealth Advocates Network is urgently hiring Utilization...

  • Travel Nurse RN

    3 weeks ago

    Baltimore, United States Health Advocates Network-Nursing Full time

    Health Advocates Network-Nursing is seeking a travel nurse RN Utilization Review for a travel nursing job in Baltimore, Maryland.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 06/17/2024Duration: 14 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelHealth Advocates Network is urgently hiring Utilization...

  • Travel Nurse RN

    2 weeks ago

    Baltimore, United States Health Advocates Network-Nursing Full time

    Job DescriptionHealth Advocates Network-Nursing is seeking a travel nurse RN Utilization Review for a travel nursing job in Baltimore, Maryland.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 06/17/2024Duration: 14 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelHealth Advocates Network is urgently...

  • Local Contract Nurse RN

    3 weeks ago

    Baltimore, MD, United States Healthcare Support Full time

    Healthcare Support is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Baltimore, Maryland.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 06/24/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Local ContractPerks: • Mon Fri, 8:00am-5:00pm • License...