RN Utilization Review Specialist
2 weeks ago
We are seeking a skilled RN Utilization Review Specialist to join our team at the Detroit Medical Center Shared Services. As a key member of our case management team, you will play a critical role in ensuring that patients receive the most appropriate level of care while promoting efficient resource utilization.
Key Responsibilities- Facilitate effective resource coordination to help patients achieve optimal health and access to care
- Ensure that care provided is at the appropriate level of care based on medical necessity
- Manage the medical necessity process for accurate and timely payment for services
- Collaborate with payors, physicians, and other healthcare professionals to coordinate care and resolve disputes
- Provide education and training to healthcare teams on effective care progression and level of care
- Active and valid RN license required
- At least two years of acute hospital or behavioral health patient care experience
- One year of hospital acute or behavioral health case management experience preferred
- Accredited Case Manager (ACM) certification preferred
As a RN Utilization Review Specialist at the Detroit Medical Center Shared Services, you will have the opportunity to work in a dynamic and fast-paced environment with a team of dedicated professionals. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.
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Nurse Utilization Review Specialist
3 weeks ago
Detroit, Michigan, United States Detroit Medical Center Full timeJob Title: Registered Nurse - Utilization ReviewAt the Detroit Medical Center, we are seeking a highly skilled Registered Nurse to join our team as a Utilization Review Specialist. This role is responsible for ensuring that patients receive the most appropriate level of care, while also optimizing resource utilization and promoting efficient healthcare...
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Nurse Utilization Review Specialist
3 weeks ago
Detroit, Michigan, United States Detroit Medical Center Full timeJob SummaryThe Detroit Medical Center is seeking a skilled Registered Nurse to fill the role of Utilization Review Specialist. This position is responsible for ensuring that patients receive the most appropriate level of care, while also promoting efficient resource utilization.Key ResponsibilitiesConduct thorough medical necessity reviews to determine the...
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Nurse Utilization Review Specialist
3 weeks ago
Detroit, Michigan, United States Detroit Medical Center Full timeJob Title: Registered Nurse - Utilization ReviewAt the Detroit Medical Center, we are seeking a highly skilled Registered Nurse to join our team as a Utilization Review Specialist. This role is responsible for ensuring that patients receive the most appropriate level of care, while also optimizing resource utilization and promoting efficient healthcare...
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Drug Utilization Review Specialist
5 days ago
Detroit, Michigan, United States destinationone Consulting Full timeJob Title: Drug Utilization Review SpecialistAt destinationone Consulting, we are seeking a highly skilled Drug Utilization Review Specialist to join our team. As a key member of our healthcare recruitment team, you will play a crucial role in evaluating medication use patterns to promote safe and effective medication therapy, ensuring optimal patient...
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Registered Nurse Utilization Review
2 weeks ago
Detroit, Michigan, United States Detroit Medical Center Full timeJob Title: Registered Nurse Utilization ReviewWe are seeking a highly skilled Registered Nurse to join our Utilization Review team at the Detroit Medical Center. As a Utilization Review RN, you will play a critical role in ensuring that patients receive the most appropriate level of care, while also optimizing resource utilization and promoting efficient...
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Registered Nurse Utilization Review
2 weeks ago
Detroit, Michigan, United States Detroit Medical Center Full timeJob Title: Registered Nurse Utilization ReviewWe are seeking a highly skilled Registered Nurse to join our team as a Utilization Review RN. In this role, you will be responsible for ensuring that patients receive the most appropriate level of care, while also promoting efficient resource utilization.Key Responsibilities:Conduct thorough assessments of...
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Registered Nurse
3 weeks ago
Detroit, Michigan, United States Detroit Medical Center Full timeJob Title: Registered Nurse - Utilization ReviewAt the Detroit Medical Center, we are seeking a highly skilled Registered Nurse to join our team as a Utilization Review Nurse. This is a full-time position that requires a strong background in nursing and a passion for delivering high-quality patient care.Job Summary:The Utilization Review Nurse will be...
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Registered Nurse
3 weeks ago
Detroit, Michigan, United States Detroit Medical Center Full timeJob Title: Registered Nurse - Utilization ReviewWe are seeking a highly skilled Registered Nurse to join our team as a Utilization Review Registered Nurse. This role will be responsible for ensuring that patients receive the most appropriate level of care, while also promoting efficient resource utilization.Key Responsibilities:Conduct thorough assessments...
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Clinical Review Specialist
4 weeks ago
Detroit, Michigan, United States w3r Consulting Full timeJob Summary:w3r Consulting is seeking a highly skilled Clinical Review Specialist to join our team. As a Clinical Review Specialist, you will be responsible for conducting thorough reviews of patient care services to ensure medical necessity, appropriate length of stay, and intensity of service.Key Responsibilities:Conduct prospective, concurrent, and...
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Clinical Review Specialist
3 weeks ago
Detroit, Michigan, United States LanceSoft Inc Full timeJob DescriptionAs a Clinical Review Specialist at LanceSoft Inc, you will play a critical role in ensuring the medical necessity of post-acute care services. Your expertise will be utilized to review and validate the appropriateness of care settings and lengths of stay, as well as appeal requests initiated by providers, facilities, and members.Key...
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RN Review Specialist
5 days ago
Detroit, Michigan, United States Strategic Staffing Solutions Full timeStrategic Staffing Solutions Contract OpportunityStrategic Staffing Solutions is currently seeking a skilled RN Review Analyst for a contract position with one of our prominent clients in Detroit, MI.Job Summary:We are looking for a detail-oriented and organized RN Review Analyst to join our team. The successful candidate will be responsible for reviewing...
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RN Review Specialist
2 weeks ago
Detroit, Michigan, United States Strategic Staffing Solutions Full timeStrategic Staffing Solutions Contract OpportunityStrategic Staffing Solutions is currently seeking a skilled RN Review Analyst for a contract position with one of our largest clients located in Detroit, MI.Job Summary:We are looking for a detail-oriented and organized RN Review Analyst to join our team. The successful candidate will be responsible for...
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Clinical Review Specialist
2 weeks ago
Detroit, Michigan, United States Strategic Staffing Solutions Full timeJob Title: Registered Nurse-Review AnalystJob Summary:Strategic Staffing Solutions is seeking a Registered Nurse-Review Analyst to join our team. As a key member of our healthcare team, you will be responsible for reviewing precertification admission and concurrent reviews for the appropriateness of the inpatient setting utilizing InterQual...
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Clinical Review Specialist
4 days ago
Detroit, Michigan, United States ICONMA Full timeJob Title: Registered Nurse-Review AnalysLocation: Detroit, MIDuration: 10-11 monthsDescription:Job Summary:We are seeking a highly skilled Registered Nurse to join our team as a Clinical Review Specialist. In this role, you will be responsible for performing prospective, concurrent, and retrospective reviews of inpatient, outpatient, ambulatory, and...
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Nurse Review Specialist
2 weeks ago
Detroit, Michigan, United States Strategic Staffing Solutions Full timeStrategic Staffing Solutions: A Leader in Healthcare StaffingWe are seeking a skilled RN Review Analyst to join our dynamic team in Detroit, MI.About the RoleAs a RN Review Analyst, you will be responsible for reviewing and analyzing medical records to ensure accuracy and quality.You will work closely with our healthcare team to identify areas for...
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Clinical Review Specialist
5 days ago
Detroit, Michigan, United States LanceSoft Full timeJob Title: Registered Nurse-Review AnalystJob Summary:We are seeking a highly skilled Registered Nurse to join our team as a Review Analyst. In this role, you will be responsible for conducting medical necessity reviews of post-acute care services to ensure compliance with established medical policy and guidelines.Key Responsibilities:Conduct prospective,...
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Clinical Reviewer
2 days ago
Detroit, Michigan, United States Genex Services, LLC. Full timeJob Title: Utilization ReviewerGenex Service LLC is seeking a skilled Utilization Reviewer to join our team. As a Utilization Reviewer, you will play a critical role in ensuring that medical treatment is necessary and appropriate for patients.Responsibilities:Perform utilization review of medical treatment requests to determine medical necessity.Collaborate...
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Travel Nurse RN Specialist
3 weeks ago
Detroit, Michigan, United States Medical Solutions Full timeTravel RN - Case Management OpportunityWe're seeking a skilled Registered Nurse (RN) to join our team as a Case Management Specialist in Detroit, MI. As a travel RN, you'll have the opportunity to work with a variety of patients and healthcare teams, utilizing your expertise in utilization review to ensure the best possible outcomes.About the RoleProvide...
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Clinical Utilization Manager
2 weeks ago
Detroit, Michigan, United States McLaren Health Care Full timeClinical Utilization Management Role **Job Summary:** McLaren Health Care is seeking a skilled Registered Nurse to join our Utilization Management team. As a Clinical Utilization Manager, you will play a critical role in ensuring that hospital admissions are based on medical necessity and that documentation is sufficient to support the level of care being...
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Clinical Utilization Manager
2 weeks ago
Detroit, Michigan, United States McLaren USA Full timeJob SummaryWe are seeking a skilled Clinical Utilization Manager to join our team at McLaren USA. As a key member of our healthcare team, you will play a critical role in ensuring the efficient use of hospital resources and promoting high-quality patient care.Key ResponsibilitiesConduct concurrent and retrospective reviews to ensure that patients receive the...