Nurse Utilization Specialist

15 hours ago


Center Line, Michigan, United States LanceSoft Full time
Job Summary:
This remote role for Nurses in Michigan requires a valid MI RN License and utilization management experience. The ideal candidate should have knowledge of post-acute InterQual criteria and be well-versed in coordination of care activities, including discharge planning. The candidate should also have demonstrated clinical knowledge and experience relative to patient care and healthcare delivery processes.

Key Responsibilities:

* Conduct utilization reviews for inpatient rehab and skilled nursing facility settings
* Coordinate care activities and discharge planning to ensure safe transitions for members
* Utilize post-acute InterQual criteria to inform review decisions
* Collaborate with healthcare teams to ensure high-quality patient care

Requirements:

* Registered Nurse with current unrestricted Michigan Registered Nurse license
* One year health insurance plan experience or managed care environment preferred
* Certification in Case Management may be preferred
* Above average computer skills
* Clinical experience in ICU, ER, or medical surgical unit preferred

What We Offer:

* Remote work opportunities
* Competitive compensation and benefits package
* Opportunities for professional growth and development

If you are a motivated and experienced Nurse looking for a new challenge, please submit your application.

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