Appeals Review Nurse

w3r Consulting; Detroit (MI); Hybrid; USD 60,000 - 80,000; Full time

Job summary

An innovative consulting firm is seeking a dedicated Registered Nurse to join their team as a Review Analyst. In this hybrid role, you will play a pivotal part in supporting medical policy development and compliance for a Medicare Advantage plan. Your expertise in clinical coding and policy writing will be essential as you collaborate with internal stakeholders to ensure regulatory adherence. This position requires strong analytical and writing skills, along with meticulous attention to detail. If you're passionate about making a difference in healthcare policy, this opportunity is perfect for you.

Qualifications

• Registered Nurse with experience in medical policy and Medicare Advantage.
• Strong skills in writing, research, and analytical tasks.

Responsibilities

• Support medical policy development and review for Medicare Advantage.
• Collaborate with internal stakeholders on regulatory compliance.

Skills

Analytical Skills

Writing Skills

Research Skills

Attention to Detail

Collaboration Skills

Education

Bachelor's in Nursing

Master's in Nursing

Tools

MS Word

Document Management Systems

Job description

Job Title: RN – Review Analyst

Location: Detroit, MI (Hybrid)

Schedule: Monday–Friday

Pay Rate: $40/hr

Summary:

Seeking a Registered Nurse to support medical policy development and review for a Medicare Advantage plan. This hybrid role involves policy writing, regulatory compliance, and collaboration with internal stakeholders. Onsite work required on occasion.

Must-Have:

RN with Bachelor's (Master’s preferred)

Experience in medical policy, Medicare Advantage, and clinical coding

Strong writing, research, and analytical skills

Excellent attention to detail and organization

Preferred:

Proficiency in MS Word and document systems

Utilization Management experience

Skilled in stakeholder collaboration and document formatting