Nurse Review Specialist
3 days ago
Duration: 10 months
Location: Remote
Pay:
$40.00/hr on W2
As a Registered Nurse Review Analyst, you will be responsible for performing prospective, concurrent, and retrospective reviews of inpatient, outpatient, ambulatory, and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service, and level of care.
You will establish care plans and coordinate care through the healthcare continuum, including member outreach assessments.
Required Skills/Experience:
• Above average computer skills (Microsoft Office)
• Clinical experience in ICU, ER, or medical surgical unit preferred
• Prefer utilization management experience
Include:
• Registered Nurse with current unrestricted Michigan Registered Nurse license required
• Two (2) to four (4) years of clinical experience, including acute patient care, discharge planning, case management, and utilization review
• Demonstrated clinical knowledge and experience relative to patient care and healthcare delivery processes
Preferred Skills/Experience:
• Bachelors 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
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