Utilization Review Nurse RN

About the role

The Utilization Review RN at Sinai Hospital works with stakeholders in the Revenue Cycle Management process and payors to ensure efficiency of utilization of resources, minimize losses and maximize reimbursement.

Responsibilities

• Medical necessity review of patient stays and referral to the physician advisor as needed
• Denial Management, including coordination with Case Management
• Maintain oversight of utilization of hospital resources

Requirements

• Education: BSN preferred; ADN required
• Licensure: Registered Nurse License - Current Maryland license or Compact Multistate License
• Experience: At least 2 years of experience in acute inpatient utilization review required

Additional Information

What We Offer:

• Impact: Join a team that values innovation and outcomes, delivering life-saving care to our youngest and most vulnerable patients.
• Growth: Opportunities for professional development, including tuition reimbursement and developing foundational skills for neonatal critical care leadership and advanced certification.
• Support: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support — improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.

Benefits

• Competitive compensation (additional compensation such as overtime, shift differentials, premium pay, and bonuses may apply depending on job)
• Comprehensive health plans
• Free parking
• Wellness programs

Why LifeBridge Health?

LifeBridge Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression.