Clinical Review Analyst
3 weeks ago
Strategic Staffing Solutions (S3) is seeking a highly skilled Clinical Review Analyst to join our team. As a Clinical Review Analyst, you will play a critical role in ensuring the quality and accuracy of healthcare services.
Job Summary:We are looking for a detail-oriented and organized individual to perform 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. The ideal candidate will have strong clinical knowledge and experience in healthcare delivery.
Key Responsibilities:- Perform thorough reviews of medical records to ensure medical necessity and appropriateness of care
- Identify and document any discrepancies or concerns related to medical necessity or quality of care
- Collaborate with healthcare providers and facilities to resolve any issues or concerns
- Develop and implement care plans to ensure optimal patient outcomes
- Stay up-to-date with changing regulations and guidelines related to healthcare delivery
- Registered Nurse with current unrestricted Michigan Registered Nurse license
- Two to four years of clinical experience in ICU, ER, or medical surgical unit
- Demonstrated clinical knowledge and experience relative to patient care and healthcare delivery
- Strong computer skills, including Microsoft Office
- Bachelor's degree in nursing, allied health, business, or related field
- One year of health insurance plan experience or managed care environment
At S3, we are committed to building trusting relationships and delivering solutions that positively impact our customers, consultants, and communities. Our four pillars are to set the bar high for what a company should do, create jobs, offer people an opportunity to succeed and change their station in life, and improve the communities where we live and work through volunteering and charitable giving.
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Healthcare Review Analyst
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Healthcare Review Analyst
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