Utilization Review Specialist

4 days ago

Baltimore, Maryland, United States LifeBridge Health Full time

Job Summary

We are seeking a skilled Utilization Review Specialist to join our team at LifeBridge Health. As a Utilization Review Specialist, you will play a critical role in ensuring the efficient use of healthcare resources while maintaining high-quality patient care.

Key Responsibilities

  • Conduct concurrent and retrospective chart reviews to identify opportunities for improvement in clinical, financial, and resource utilization.
  • Develop and implement interventions to decrease avoidable delays and denial of payment.
  • Collaborate with healthcare teams to ensure seamless care transitions and optimal patient outcomes.
  • Stay up-to-date with industry trends, regulations, and best practices in utilization review and case management.

Requirements

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

Preferred Qualifications

  • Experience in utilization review and discharge planning.
  • Knowledge of healthcare regulations and industry standards.

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 while promoting a culture of excellence and innovation.

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