Care Review Clinician - UR RN

Healthcare Support Staffing; Troy (MI); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive salary, negotiable based on experience

Acquire new skills

Positive work environment

Job summary

A healthcare staffing firm is seeking an experienced Registered Nurse in Michigan to provide utilization review for healthcare services. Candidates should possess a valid RN license and experience in both utilization review and Interqual. This opportunity offers a competitive salary, supportive work environment, and the chance to acquire new skills. If you are looking to advance your career, this role may be ideal for you.

Qualifications

• At least one year of experience in a Managed Care or Provider environment.
• Registered Nurse License in Michigan is required.
• Experience with Interqual for a minimum of one year.
• 2-4 years of clinical practice is preferred.

Responsibilities

• Conduct concurrent review and prior authorizations according to Molina policy.
• Identify benefits, eligibility, and length of stay for treatments.
• Provide utilization review for Medicaid and Medicare services.

Skills

Utilization Review background

RN License in Michigan

Interqual experience

Clinical practice experience

Education

RN License in Michigan

Job description

Overview

HealthCare Support Staffing, Inc. (HSS) is a proven industry-leading national healthcare recruiting and staffing firm. HSS places talented healthcare professionals in clinical and non-clinical positions with healthcare facilities across the United States. We maintain strong relationships with top providers in healthcare to provide fast access to career opportunities.

Job Description

Are you an experienced Registered Nurse looking for a new opportunity with a prestigious healthcare company? Do you want 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!

Responsibilities

• Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team
• Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures
• Providing utilization review for the Medicaid and Medicare line of business. Primarily inpatient, skilled nursing facilities, rehab, behavioral health, and home healthcare

Qualifications

• Utilization Review background in either Managed Care of Provider environment (at least one year)
• RN License in Michigan
• Interqual experience (at least one year)
• Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management

Benefits

• Competitive salary, negotiable based on relevant experience
• Acquire new skills and broaden your experience / expertise
• Fun and positive work environment

Hours for this Position:

Additional Information

Interested in hearing more about this great opportunity?

If you are interested in applying to this position, please click Apply Now and email your resume to Michael Grifon.