Utilization Review and Case Management RN

4 weeks ago


Essex, Maryland, United States LifeBridge Health Full time
Job Summary:

As a Utilization Review and Case Management RN with LifeBridge Health, you will play a critical role in ensuring the efficient use of healthcare resources. Your primary responsibility will be to conduct concurrent and retrospective chart reviews to identify areas for improvement and implement interventions to reduce avoidable delays and denial of payment.

Key Responsibilities:

• Conduct thorough chart reviews to identify clinical, financial, and resource utilization information
• Develop and implement strategies to reduce avoidable delays and denial of payment
• Collaborate with healthcare teams to ensure seamless care coordination
• Analyze data to identify trends and areas for improvement

Requirements:

• Bachelor of Science in Nursing degree from a CCNE-accredited institution
• Maryland Registered Nurse License
• American Heart Association CPR Certification
• Strong critical thinking skills and ability to perform clinical/chart review efficiently
• Experience in Utilization Review and Discharge Planning

About LifeBridge Health:

LifeBridge Health is a leading healthcare provider in Maryland, serving over 1 million patients annually. Our team of 13,000 healthcare professionals is dedicated to delivering high-quality care and improving the health of our community. We strive to CARE BRAVELY and make a positive impact on the lives of those we serve.
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