Healthcare Review Specialist
2 days ago
We are seeking an experienced Healthcare Review Specialist to join our team at Iconma LLC. As a Healthcare Review Specialist, you will play a critical role in ensuring the quality and appropriateness of healthcare services provided to our clients.
The ideal candidate will have a strong background in nursing and experience in utilization review, case management, and discharge planning. You will be responsible for conducting thorough reviews of medical records to determine medical necessity and appropriateness of care, establishing care plans, and coordinating care through the healthcare continuum.
A Bachelor's degree in nursing or a related field is preferred, and a current unrestricted Michigan Registered Nurse license is required. We offer a competitive salary, excellent growth and advancement opportunities, and a comprehensive benefits package.
Responsibilities include:
- Conducting thorough reviews of medical records to determine medical necessity and appropriateness of care
- Establishing care plans and coordinating care through the healthcare continuum
- Collaborating with healthcare providers and other stakeholders to ensure seamless care transitions
- Maintaining accurate and detailed records of patient information and care plans
Requirements include:
- Two (2) to four (4) years of clinical experience in acute patient care, discharge planning, case management, and utilization review
- One (1) year health insurance plan experience or managed care environment preferred
- Registered Nurse with current unrestricted Michigan Registered Nurse license required
- Certification in Case Management may be preferred based upon designated department assignment
We are committed to providing a safe and inclusive work environment for all employees.
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