As-Needed Utilization Review Registered Nurse, Day Shift

Under general supervision, utilize clinical knowledge and critical thinking skills to provide oversight of appropriate admission status and utilization of hospital resources facilitating quality, cost-effective patient outcomes. Works collaboratively with interdisciplinary staff internal and external to the organization ensuring maximum reimbursement for the hospital through the utilization review process. Active participation and attendance in daily multidisciplinary rounds. Responsible for analyzing clinical information and performing timely concurrent and retrospective reviews using InterQual screening software to identify appropriate medical necessity, length of stay, and level of care based upon evidence based clinical guidelines.

Education :

Bachelor of Science in Nursing (BSN) OR Advanced Practitioner licensure

Licensures / Certifications :

• Current state of Maryland Registered Nurse, Physician Assistant, or Nurse Practitioner license
• Certification in Utilization Management and / or Care Management highly desired.

Experience :

Seven (7) years diversified, progressive experience in acute care and / or other settings within the continuum required.

Two (2) years of Case Management which includes Utilization Review, Discharge Planning and working with Re-Admission Initiatives preferred.

Skills :

Principal Duties and Responsibilities :

All roles must demonstrate GBMC Values :

Respect

I will treat everyone with courtesy. I will foster a healing environment.

Excellence

I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.

Accountability

I will be professional in the way I act, look and speak. I will take ownership to solve problems.

Teamwork

I will be engaged and collaborative. I will keep people informed.

Ethical Behavior

I will always act with honesty and integrity. I will protect the patient.

Results

I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.

Pay Range

$31.09 - $50.22

Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.

COVID-19 Vaccination

All applicants must be fully vaccinated against Covid-19 or obtain a GBMC approved medical or religious exemption prior to starting employment at GBMC Healthcare, to include Gilchrist and GBMC Health Partners.

Equal Employment Opportunity

GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.