Utilization Review Nurse - Psych RN Experience Position Summary: Conducts concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment. Essential Functions: Chart Review Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource consumption. Denial Management Monitors and identifies patterns or trends in utilization management. Care Coordination Coordinates with the Care Manager to achieve optimal and efficient patient outcomes, while decreasing length of stay and avoid delays and denied days. Qualifications/Requirements Education/Knowledge: Basic professional knowledge; equivalent to a Bachelor's degree; working knowledge of theory and practice within a specialized field Education Discipline: Minimal degree requirement: Bachelor of Science in Nursing. Experience: 3-5 years. Psych RN Experience Must possess strong critical thinking skills, have an ability to perform clinical/chart review and abstract information efficiently Certifications, Licenses, Registrations: Maryland Registered Nurse License American Heart Association BLS Certification LifeBridge Health
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About the EmployerOur vision is to create options and excellence in education, empowering all student to reach their full potential.Our mission is to provide a relevant, high quality education within an inclusive and culturally respectful environment, preparing all ...
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