Offer summary

Qualifications:

Registered Nurse with a current Michigan driver's license., Associate Degree or nursing diploma required., Two years of patient care experience, preferably in ER or ICU., Expertise in medical terminology and familiarity with Microsoft Office Suite..

Key responsibilities:

Process inpatient admission requests using InterQual criteria to assess medical necessity.

Perform admission approvals and denials based on medical decisions.

Conduct telephone triage and benefit interpretation.

May be required to work onsite if technical issues arise with their computer.

Job description

Department: Commercial Inpatient Pr

Will this position be required to work onsite for any reason at any time? Yes. If their computer is not working, they may be asked to work onsite or to come into the office to have it fixed.

Engagement Description –
The RN Analyst Reviewer role encompasses the processing of inpatient admission requests utilizing InterQual criteria to determine the medical necessity of an inpatient status. The RN Review Analyst will perform admission approvals, admission denials per MD decision, telephone triage, and benefit interpretation.

Top 3 Required Skills/Experience –
• Registered Nurse with current Michigan driver's license
• Associate Degree or nursing diploma required.
• Two (2) years patient care experience – ER or ICU preferred

Required Skills/Experience – The rest of the required skills/experience. Include:
• Expertise in the use of medical terminology
• Familiar with Microsoft Office Suite including Teams

Preferred Skills/Experience – Optional but preferred skills/experience. Include:
• Triage, case management or utilization review experience
• InterQual knowledge
• Experience with Clinical Care Advance

Education/Certifications – Include:
• Associate's Degree or Nursing Diploma

Required profile