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Registered Nurse-Review Analys

72% Flex

Remote:

Full Remote

Experience:

Mid-level (2-5 years)

Work from:

Michigan (USA)

Offer summary

Qualifications:

Bachelor's degree in nursing or related field preferred, 2-4 years of clinical experience required, Registered Nurse with current Michigan license.

Key responsabilities:

Conduct reviews of medical services for appropriateness
Establish care plans and coordinate healthcare services

ICONMA Human Resources, Staffing & Recruiting Large https://www.iconma.com/

1001 - 5000 Employees

See more ICONMA offers

Job description

Your missions

Registered Nurse-Review Analys

Location: Remote
Duration: 6- 12 months

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.
Bachelors 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.

Dept. Registered Nurse-Review Analys

Required profile

Experience

Level of experience: Mid-level (2-5 years)

Industry :

Human Resources, Staffing & Recruiting

Spoken language(s):

English

Check out the description to know which languages are mandatory.

Hard Skills

Clinical Experience Utilization Management Case Management Health Insurance Knowledge

Soft Skills

Interpersonal Skills
Attention to Detail
Critical Thinking
Problem Solving

Are you interested?

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