Utilization Review Nurse RN - PRN

Sinai Hospital's Utilization Review operates as a distinct specialty service line of physician advisors, nurses, and support staff who ensure hospital stays are clinically appropriate and fully covered by the patient's insurance. The team focuses on appropriate resource use, operational efficiency, and timely patient services while maintaining or improving quality of care.

About the Role/Unit:

The PRN 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.

*This PRN position supports the ED and will be scheduled based on the needs of the dept.*

Key Responsibilities:

• Medical necessity review of patient stays and referral to the physician advisor as needed
• Denial Management, including coordination with Case Management
• Monitor 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 ED utilization review required

Must Live in One of the Following Districts/States: District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia

Pay Range: $50.00 to $50.00

About Sinai Hospital

Sinai Hospital of Baltimore is a nationally recognized academic medical center, a designated Level II Trauma Center, and the largest community hospital in Maryland. As part of LifeBridge Health - one of the region's most comprehensive healthcare systems - Sinai delivers advanced care with a mission to improve the health of the communities we serve, and to take care of the people who take care of patients.