Offer summary

Qualifications:

Valid Michigan RN license is required., Experience in utilization management and post-acute reviews., Knowledge of InterQual criteria and care coordination., Clinical experience in ICU, ER, or medical-surgical units is preferred..

Key responsibilities:

Conduct utilization reviews for inpatient rehab and skilled nursing facilities.

Coordinate care activities and discharge planning to ensure safe member transitions.

Utilize InterQual criteria to assess patient needs.

Support the health insurance plan with clinical expertise.

Established in 2000, LanceSoft is a pioneer in delivering top-notch Global Workforce Solutions and IT Services to a diverse clientele. As a Certified MBE and Woman-Owned organization, we pride ourselves on fostering global cross-cultural connections that advance both the careers of our employees and the success of our clients' businesses. At LanceSoft, our mission is clear: to leverage our global network to seamlessly connect businesses with the right talent and individuals with the right opportunities, all without bias. We believe in providing Global Workforce Solutions with a personalized, human touch. Our comprehensive range of services spans various domains, encompassing temporary and permanent staffing, Statement of Work (SOW) arrangements, payrolling, Recruitment Process Outsourcing (RPO), application design and development, program/project management, and engineering solutions. Currently, our team of over 5,000 professionals caters to 110+ enterprise clients worldwide, including Fortune companies. Our client base represents a diverse spectrum of industries, including Banking & Financial Services, Semiconductor/VLSI, Technology, Healthcare & Life Sciences, Government, Telecom & Media, Retail & Distribution, Oil & Gas, and Energy & Utilities. Headquartered in Herndon, VA, LanceSoft operates 32+ regional offices across the North America, Europe, Asia, and Australia. We also have nine delivery centers strategically located in India in Bangalore, Indore, Noida, Baroda, Hyderabad, Bhubaneshwar, Dehradun, Goa, and Aligarh to further enhance our client service capabilities.

Job description

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.

Required profile