Utilization Review Nurse (RN), Day Shift, Inpatient Rehabilitation

Adventist Rehabilitation - Rockville

If you are a current Adventist HealthCare employee, please click this link to apply through your Workday account.

 

Adventist HealthCare seeks to hire an experienced Utilization Review Nurse for our Inpatient Rehabilitation department who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing.

As a Utilization Review Nurse, you will:
• Submit and follow up on Continuing Stay Reviews (CSRs) on patients with non-Medicare third-party payors and manage insurance benefit during length of stay
• In coordination with the Care Navigation team, complete initial discharge needs, psychosocial assessment, and review of clinical needs of patients with focus on ensuring patient’s safe discharge
• Collaborate with the managed care department to identify payor behaviors and escalate issues, work with third-party payors, care providers and review organizations to ensure proper utilization of patient care resources
• Review patient records in regard to compliance and ensure the need for inpatient rehabilitation services are clearly documented
• Provide education support and training for clinical staff regarding appropriate clinical documentation
• Communicate with third-party payors, care providers, and review organizations to ensure proper utilization of patient care resources to prevent initial denials
• Work with third-party payors on denials
• Interact with Physicians and Care Navigation staff, Admitting and Accounts Receivable staff, and assist with troubleshooting issues on an ongoing basis
• Build relationships and coordinate with payer sources to ensure proper reimbursement for services provided by inpatient rehabilitation
• Participate in departmental and hospital-wide process improvement, program team, or other hospital-wide programs
• Other duties as assigned by department leaders

Qualifications include:
• RN-BSN preferred, but RN-AA acceptable
• Typing 50+ wpm, strong computer skills
• 3-5 years in Utilization Review and Case Management Discharge planning
• Active Maryland RN license
• Active American Heart Association Basic Life Support (BLS) certification required

Work Schedule:

Monday-Friday 8 hours. Will be required to be onsite at both Rockville and White Oak locations

#GR8 Allied Healthcare

Pay Range:

$77,313.60 - $115,980.80

In cases where the range is displayed as a $0 amount or if the position is Per Diem (offering a fixed rate), salary discussions will occur during the screening process.

United States of America (Exempt)

At Adventist HealthCare our job is to care for you.

We do this by offering:

• Work life balance through nonrotating shifts

• Recognition and rewards for professional expertise

• Free Employee parking

• Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire

• Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available)

• Paid Time Off

• Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period 

• Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care, and critical illness & accident insurance

• Subsidized childcare at participating childcare centers

• Tuition Reimbursement

• Employee Assistance Program (EAP) support

As a faith-based organization, with over a century of caring for the communities in the Maryland area, Adventist HealthCare has earned a reputation for high-quality, compassionate care. Adventist HealthCare was the first and is the largest healthcare provider in Montgomery County.

If you want to make a difference in someone’s life every day, consider a position with a team of professionals who are doing just that, making a difference.

Join the Adventist HealthCare team today, apply now to be considered!

COVID-19 Vaccination

Adventist HealthCare strongly recommends all applicants to be fully vaccinated for COVID-19 before commencing employment. Applicants may be required to furnish proof of vaccination.

Tobacco and Drug Statement

Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire