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.
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
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
Must Live in One of the Following Districts/States: District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia
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
Opportunities for professional development, including tuition reimbursement and developing foundational skills for neonatal critical care leadership and advanced certification
A culture of collaboration with resources like unit-based practice councils and advanced clinical education support