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Clinical Nurse Review Specialist

2 months ago

Detroit, Michigan, United States Strategic Staffing Solutions Full time
Strategic Staffing Solutions (S3) is excited to announce a new opportunity

Position: RN Clinical Review Consultant

Location: Remote (Candidates must reside in Michigan)

Contract Duration: 12+ Months

Role Type: W2 Contract Engagement

Engagement Overview

Our Utilization Management Program is centered around provider interactions, necessitating professional communication with clinical staff from Acute Inpatient Hospitals and Post-Acute Care settings. This role does not involve direct patient interaction.

The primary objective of the Utilization Management Program is to ensure that members receive care in the most suitable environment, tailored to the severity of their medical conditions and the intensity of services required in an inpatient context.

The role of the Registered Nurse involves a thorough review of clinical documentation submitted by healthcare facilities, the application of InterQual criteria, and effective communication (both written and verbal) with clinical personnel, both internally and externally. Please note that this position does not entail claims review.

Qualifications:
  • A minimum of 2 years of acute care experience with a valid Registered Nurse license in Michigan; ICU/ER experience is preferred.
  • Experience should not be limited to specialized fields such as NICU, OB, Behavioral Health, or Substance Abuse.
  • Familiarity with InterQual, MCG, or other utilization review methodologies.
  • Proficient computer skills; typing speed of 40+ WPM.
  • Must be a resident of Michigan.
The S3 Commitment

At Strategic Staffing Solutions, our mission is to cultivate trust and deliver impactful solutions for our clients, consultants, and communities. Our core values include:
  • Setting high standards for corporate responsibility.
  • Creating employment opportunities.
  • Empowering individuals to achieve success and improve their circumstances.
  • Enhancing the communities in which we operate through volunteerism and charitable initiatives.
As a member of the S3 team, you will have access to a comprehensive benefits package that may include:
  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • 401(k) Retirement Plan
  • Paid Time Off
  • Life and Disability Insurance Options
  • Flexible Spending Accounts
  • Tuition Reimbursement
Job ID: JOB-237255