Remote Utilization Review RN — Optimize Care & Coverage

LifeBridge Health; Owings Mills (MD); Remote; USD 55,000 - 87,000; Full time

Job summary

LifeBridge Health's Sinai Hospital Utilization Review team is seeking a remote, full-time RN to conduct initial, concurrent and retrospective chart reviews, applying UR criteria to ensure hospital stays are appropriate and fully covered by insurance. You will coordinate with Care Managers, payors, and external reviewers to minimize denials and delays while supporting patient care goals.

Qualifications include ADN or BSN with 3–5 years UR experience and Maryland RN licensure or eligibility.

Qualifications

• BSN preferred; ADN required.
• 3–5 years of Utilization Review experience in an acute hospital setting preferred.

Responsibilities

• Review medical records using UR criteria to assess clinical, financial, and resource use.
• Enter clinical reviews into the software program and document actions taken.
• Coordinate with Care Manager, social work, and payors to minimize denials and delays.
• Identify opportunities for expedited appeals and communicate with patient access personnel.
• Assist in communication with patients and families during discharge planning and address payer issues.

Skills

Utilization Review

RN

Communication

Care coordination

Education

BSN preferred

ADN required

Job description

LifeBridge Health's Sinai Hospital Utilization Review team is seeking a remote, full-time RN to conduct initial, concurrent and retrospective chart reviews, applying UR criteria to ensure hospital stays are appropriate and fully covered by insurance. You will coordinate with Care Managers, payors, and external reviewers to minimize denials and delays while supporting patient care goals.

Qualifications include ADN or BSN with 3–5 years UR experience and Maryland RN licensure or eligibility.