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Utilzation Review

Remote:

Full Remote

Work from:

Michigan (USA)

Offer summary

Valid MI RN License, Utilization management experience, Experience in post-acute settings.

1001 - 5000 Employees

Job Description:

This position will be remote role for Nurses in Michigan
Should have a valid MI RN License
Should Have utilization management experience.
Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing facility settings previously.
The candidate should be well versed in coordination of care activities along with discharge planning which is a plus for this role in ensuring members are transitioned safely following care.
In addition, the candidate should have knowledge of post-acute InterQual criteria that is utilized in this role.

Requirements:

Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.
One 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.
Above average computer skills
Clinical experience in ICU, ER, or medical surgical unit preferred.