Utilization Review Registered Nurse, Monday-Friday 9:00AM-5:30PM, 1 holiday/year, on-call every 5th weekend
Gilchrist(1 month ago)
About this role
Under general supervision, the RN uses utilization review processes and InterQual criteria to determine patient status and appropriate level of care, coordinating with care teams to support quality, cost-effective outcomes for hospital patients. The role collaborates with interdisciplinary staff and payers to ensure timely authorizations, discharge planning, and adherence to regulatory standards.
Required Skills
- InterQual
- Utilization Review
- Case Management
- Discharge Planning
- Regulatory Standards
- EMR Review
- Payer Relations
- Critical Thinking
- Analytical Skills
- Communication
Qualifications
- Maryland RN License
- BSN
- Utilization Management Certification (Desirable)
- Care Management Certification (Desirable)
About Gilchrist
gilchristcares.orgGilchrist is Maryland’s leading nonprofit provider of serious illness and end-of-life care, providing care at every stage of serious illness.
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