Clinical Liaison: Care Coordination & Payer Access

Detroit Medical Center; Detroit (MI); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical/Dental/Vision

401(k) with match

Generous PTO

Continuing education

Health Savings Account

Employee Assistance program

Job summary

DMC Rehabilitation Institute of Michigan is seeking a PRN Rehab Nurse to apply medical necessity criteria, assess patient admission needs, and coordinate care across acute and post-acute settings. The role interfaces with patients, families, physicians, and payers to ensure appropriate admission criteria are met.

Responsibilities include pre-admission assessments, collaboration with interdisciplinary teams, and participation in quality improvement activities.

Qualifications

• Graduate from an accredited school of nursing with a Bachelor’s degree or equivalent.
• 3–5 years clinical/nursing experience; preferred with target population.
• Current licensure as a Registered Nurse in Michigan; may require additional licenses as PT/OT/SLP in MI.

Responsibilities

• Apply medical necessity criteria to determine appropriate level of care at patient access points.
• Coordinate information gathering for insurance authorization across sources.
• Communicate with patient, family, medical team, and payers as needed.
• Participate in Utilization Review committee processes.
• Contribute to quality improvement activities and maintain payer criteria knowledge.
• Establish and maintain effective relationships with physicians and staff.

Skills

Analytical ability

Fiscal skills

Interpersonal skills

Communication skills

InterQual

Flexible schedule

Leadership

Stress management

Third party contracts

Education

Bachelor's degree in nursing or related field

MI RN license

PT/OT/SLP license in MI

Job description

DMC Rehabilitation Institute of Michigan is seeking a PRN Rehab Nurse to apply medical necessity criteria, assess patient admission needs, and coordinate care across acute and post-acute settings. The role interfaces with patients, families, physicians, and payers to ensure appropriate admission criteria are met.

Responsibilities include pre-admission assessments, collaboration with interdisciplinary teams, and participation in quality improvement activities.