Dice

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.. Prefer utilization management experience.

registered nurse

Dice is the leading career destination for tech experts at every stage of their careers. Our client, Team-Soft, LLC, is seeking the following. Apply via Dice today! Job Title: Registered Nurse - Review Analys Location: Detroit, MI, 48243 - Onsite Duration: 10+ Months Contract Job Description: Engagement Description: <ul><li>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.</li><li>May establish care plans and coordinate care through the health care continuum including member outreach assessments.</li><li>Bachelors degree in nursing, allied health, business, or related field preferred.</li><li>Two (2) to four (4) years of clinical experience which may include acute patient care, discharge planning, case management, and utilization review, etc.</li><li>Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.</li><li>One (1) year health insurance plan experience or managed care environment preferred.</li><li>Registered Nurse with current unrestricted client Registered Nurse license required.</li><li>Certification in Case Management may be preferred based upon designated department assignment. </li></ul>Requested criteria: <ul><li>Above average computer skills (Microsoft office). Clinical experience in ICU, ER, or medical surgical unit preferred.</li><li>Prefer utilization management experience.</li><li>May be required to come into the office for meetings and training. </li></ul>Registered Nurse - Review Analys @Detroit, MI, 48243 - Onsite

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