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Detroit, United States TekWissen LLC Full time
Job DescriptionJob DescriptionOverview: TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc. Title: Registered Nurse-Review AnalysWork Location: Detroit, MI, 48243Duration: 11 MonthsJob Type: Contract Work Type: RemoteDept: Commercial Inpatient Pr Engagement Description:
  • Client UM Program is provider focused requiring professional interaction with Acute Inpatient Hospital/Post-Acute Care clinical staff and physicians.
  • Program is not member/patient facing.
  • Goal of UM Program is to ensure member is in the most appropriate setting based on severity of their illness and intensity of services being provided in the inpatient setting.
  • Role for clinical Registered Nurse requires review of clinical documentation provided by the facility, application of InterQual criteria, and ability to professionally interact (written, telephonic and verbal) with clinical staff internally and externally.
  • Role does not involve review of claims.
Requirements:
  • 2 years acute care experience with an unrestricted Registered Nurse license
  • ICU/ER preferred *should not just be 2 years in a specialized field such as NICU/OB/BH/Substance Abuse *
  • InterQual/MCG or other utilization review experience
  • Advanced computer skills
  • 40+ WPM typing
TekWissen Group is an equal opportunity employer supporting workforce diversity.