LPN - Utilization Review

3 weeks ago


Hagerstown, United States Brook Lane Full time

This professional must understand patient level of care and medical necessity criteria as it relates to the utilization process and revenue cycle. Effective communication skills regarding patient care are imperative when dialoging with team members, physicians, and payers. Upon reviewing the record, it must be examined comprehensibly to ensure correctness and completeness. This professional will need to have a broad knowledge of disease processes, courses of treatment, evidenced based practice, community resources, and have the ability to accurately discuss the patient's medical status and link to an appropriate service for discharge planning. Possessing a positive attitude is expected at all times and the ability to function in a collaborative team is required. Education - Licensed Practical Nurse with previous utilization management experience required. Registered Nurse preferred. Experience - Minimum of 2 years acute care experience required. Licensure/Certification - Current license to practice as a Licensed Practical Nurse in the State of Maryland, or if resident of a state that participates in Nurse Multi-State Compact agreement, holds LPN license from that state that is designated as "Compact" or "Multi-State Privilege" using primary source verification and provides additional documentation as required by the Maryland Board of Nursing. LPN license from a compact state with a designation of "Single State" does not meet the requirement and nurse must obtain a Maryland license. Knowledge/Skills/Abilities - Knowledge of utilization review criteria preferred, computer skills required, strong communication skills, ability to take directions from several individuals, ability to prioritize work and multi-task to achieve desired results, ability to work in a team. Caring for Our Team We offer a comprehensive benefits package to support our employees' well-being and professional growth. Benefits include health, dental, and vision insurance available starting the first day of the month following 30 days of employment, along with life insurance, short and long-term disability coverage. Paid Time Off begins accruing from day one, and we also provide a 401k plan, an education assistance program, and an employee assistance program. Additionally, employees working evening, night, or weekend shifts may be eligible for a shift differential, adding even more value to your role. Strength Through Diversity Meritus Health believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Meritus Health, and we expect a record of achievement and advancement as we meet our mission. Our commitment to equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to create joy at work and reach their potential. Happy to Help At Meritus, we believe in a collaborative and caring work environment. Interactions are an opportunity to learn, listen and to be there for one another. Therefore, we provide warm welcomes, hospitality-driven closures, and are always Happy to Help.



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