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Clinical Utilization Review Specialist

2 months ago


Baltimore, Maryland, United States LifeBridge Health Full time
Utilization Review and Case Management RN - Part Time, Weekends

Job Summary

We are seeking a skilled RN to join our team as a Utilization Review and Case Management RN. This part-time, weekend position will involve conducting concurrent and retrospective chart reviews to identify opportunities for improvement in clinical, financial, and resource utilization.

Key Responsibilities

  • Conduct 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
  • Provide education and support to patients and families to promote optimal health outcomes

Requirements

  • Bachelor of Science in Nursing degree from a CCNE-accredited institution
  • Current Maryland Registered Nurse License
  • American Heart Association CPR Certification
  • Strong critical thinking and analytical skills
  • Experience in utilization review and discharge planning

About LifeBridge Health

As one of the largest healthcare providers in Maryland, LifeBridge Health is committed to delivering high-quality, patient-centered care to our community. We strive to CARE BRAVELY for over 1 million patients annually and are proud to be a leader in healthcare innovation.