Care Review Clinician

Healthcare Support Staffing; Troy (MI); On-site; USD 70,000 - 90,000; Full time

Job summary

A national healthcare staffing firm is seeking an experienced Registered Nurse for a position focused on Utilization Review. This role involves collaborating to enhance care continuity and conducting reviews for Medicaid and Medicare patients. The ideal candidate will have relevant experience in a managed care environment, specifically with Interqual. This opportunity offers the chance to further your career with a prestigious healthcare company in Michigan.

Qualifications

• At least one year of experience in Utilization Review, preferably in Managed Care or Provider environment.
• Minimum one year of experience with Interqual.
• Must be a Registered Nurse licensed in Michigan.

Responsibilities

• Identify benefits and expected stay length for member treatments.
• Participate in interdepartmental collaboration for care continuity.
• Conduct utilization reviews for Medicaid and Medicare.

Skills

Utilization Review background

Interqual experience

Registered Nurse license

Education

Registered Nurse license (MI)

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Are you an experienced Registered Nurse looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Daily Responsibilities:

• Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures

• Participates in interdepartmental integration and collaboration to enhance the continuity of care for members including Behavioral Health and Long Term Care

• Providing utilization review for the Medicaid and Medicare line of business. Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare

Hours for this Position:

Qualifications

Qualifications/ Requirements:

• Utilization Review background in either Managed Care of Provider environment (at least one year)

• Interqual experience (at least one year)

• Registered Nurse in the state of Michigan

Additional Information

Interested in hearing more about this great opportunity? Reach out to Michael Grifon at HealthCare Support Staffing for IMMEDIATE, SAME-DAY consideration. Interviews are being held THIS WEEK and immediate offers will be extended. Click I'M INTERESTED for more information; we look forward to hearing for you!