Utilization Review and Case Management RN

5 days ago


Baltimore, Maryland, United States LifeBridge Health Full time

Job Summary

LifeBridge Health is seeking a skilled Utilization Review and Case Management RN to join our team. As a Utilization Review and Case Management RN, you will be responsible for conducting concurrent and retrospective chart reviews to identify opportunities for improvement in clinical, financial, and resource utilization.

Key Responsibilities

  • Conduct thorough chart reviews to identify areas for improvement in clinical, financial, and resource utilization
  • Develop and implement interventions to reduce avoidable delays and denial of payment
  • Collaborate with healthcare teams to ensure seamless care transitions and optimal patient outcomes
  • Provide education and support to patients and families to promote self-management and independence
  • Participate in quality improvement initiatives to enhance patient care and reduce costs

Requirements

  • Bachelor of Science in Nursing degree from an accredited institution
  • Current Maryland Registered Nurse License
  • American Heart Association CPR Certification
  • Strong critical thinking and analytical skills
  • Excellent communication and interpersonal skills

Preferred Qualifications

  • Experience in utilization review and case management
  • Knowledge of healthcare regulations and policies
  • Ability to work in a fast-paced environment and prioritize multiple tasks

About LifeBridge Health

LifeBridge Health is a leading healthcare provider in Maryland, serving over 1 million patients annually. We are committed to delivering high-quality, patient-centered care and are seeking talented professionals to join our team.



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