Note:- Only Michigan State License Required
Registered Nurse Review Analyst
Must have 2-4 years of clinical experience which may include post-acute care, home care, acute patient care, discharge planning, case management, and utilization review, and caring for aging population in the home or post-acute care setting, etc.
Payrate: $40/hr.
Location: 500 Renaissance Center Detroit Michigan 48243
Shift: Varied shift schedule, 5x8s,Duration: 52 weeks
Required:
- Michigan State License
- 2 year of clinical experience
- 1 year health insurance plan experience or managed care environment preferred.
RESPONSIBILITIES
Use established medical policy and guidelines to perform prospective, concurrent, and retrospective medical necessity review of post-acute care services to ensure medical necessity for appropriate setting, appropriate length of stay, including appeal requests initiated by providers, facilities and members. Will coordinate care through the health care continuum including member outreach. Provides support and alternative care support for member not appropriate for post-acute care service as well formulate discharge readiness for members transitioning from a post-acute care setting to a lower level of care.
Job Type: Contract
Pay: From $40.00 per hour
Healthcare setting:
Schedule:
Experience:
- Clinical: 3 years (Preferred)
- health insurance plan or managed care environment preferred.: 2 years (Preferred)
License/Certification:
- RN Michigan State License (Required)
Work Location: Remote