Remote RN Review Analyst – Michigan

Job Title: RN Review Analyst

Location: 100% Remote

Duration: 12+ Months

Department: Commercial Inpatient Pr

Engagement Description –

Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members. May establish care plans and coordinate care through the health care continuum including member outreach assessments.

Bachelor’s degree in nursing, allied health, business, or related field preferred.

Two (2) to four (4) years of clinical experience which may include acute patient care, discharge planning, case management, and utilization review, etc.

Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.

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.

Education/Certifications – Include:

• Associate degree or nursing diploma

Job Type: Contract

Pay: $35.00 – $38.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Application Question(s):

• Do you have valid RN Michigan License?

Work Location: Remote