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Registered Nurse Review Analyst

3 months ago

Detroit, United States Strategic Staffing Solutions Full time
Title: RN Review Analyst

Location: Detroit, MI (Remote however must be local to Michigan)

Duration: 12+ Months

Role Type: W2 Contract Engagement

Pay Rate: $39-42/HR

Engagement Description

Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members. May establish care plans and coordinate care through the health care continuum including member outreach assessments.

Top 3 Required Skills/Experience
  • Above average computer skills (Microsoft office).
  • Clinical experience in ICU, ER, or medical surgical unit preferred.
  • Prefer utilization management experience.
Required Skills/Experience
  • Registered Nurse with current unrestricted Michigan Registered Nurse license required.
  • Two (2) to four (4) years of clinical experience which may include acute patient care, discharge planning, case management, and utilization review, etc.
  • Demonstrated clinical knowledge and experience relative to patient care and health care delivery
Preferred Skills/Experience
  • Bachelor's degree in nursing, allied health, business, or related field preferred.
  • One (1) year health insurance plan experience or managed care environment preferred.
Education/Certifications
  • Current unrestricted Michigan Registered Nurse license required.

Job ID: JOB-236996
Publish Date: 07 Aug 2024