Registered Nurse

w3r Consulting; Detroit (MI); Remote; USD 80,000 - 100,000; Part time

Job summary

A leading company is seeking a Registered Nurse-Review Analyst for a remote position. The role involves reviewing precertification requests, conducting telephone triage, and applying clinical guidelines. Candidates should have an active RN license and at least 2 years of acute care experience, preferably in ICU or ER. Strong communication and organizational skills are essential. This contract position offers a pay rate of $40.00/hr and is ideal for those with experience in utilization review.

Qualifications

• Minimum 2 years of acute care RN experience with an unrestricted RN license.
• Background in ICU or ER preferred.

Responsibilities

• Review precertification requests and hospital admission approvals.
• Conduct telephone triage and respond to benefit-related inquiries.
• Apply clinical guidelines to determine medical necessity.

Skills

Communication

Organizational Skills

Computer Proficiency

Multitasking

Education

Registered Nurse (RN) License

Tools

InterQual

MCG

Job description

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This range is provided by w3r Consulting. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$40.00/hr - $40.00/hr

Direct message the job poster from w3r Consulting

Service Delivery Manager @ TalentRupt Inc. | Staffing Operations

Job Title – Registered Nurse-Review Analyst

Duration – 7 months

Location - Remote.

Pay: $40.00/hr on W2.

I would also appreciate receiving an updated copy of your resume for our discussion and please do share your Active License/certifications.

This RN Utilization Review position is responsible for:

• Reviewing precertification's and admission approvals
• Conducting telephone triage
• Entering and referencing clinical and member data via computer systems
• Applying clinical judgment and criteria (InterQual/MCG preferred) in real-time determinations

Top 3 Required Skills/Experience:

• Minimum 2 years of acute care RN experience with an unrestricted RN license
• Background in ICU or ER (Generalized acute experience preferred over highly specialized roles like NICU/OB/BH/Substance Abuse)
• Exposure to or experience with InterQual, MCG, or other utilization review criteria
• Strong computer proficiency
• Typing speed of 40+ WPM
• Excellent verbal and written communication
• High organizational and multitasking skills

What You’ll Do:

• Review precertification requests and hospital admission approvals for clinical appropriateness.
• Conduct telephone triage and respond to benefit-related inquiries from providers or members.
• Apply clinical guidelines such as InterQual or MCG to determine medical necessity.
• Document and reference case details using internal computer systems and electronic records.
• Interpret and communicate health plan benefits and coverage determinations.
• Work independently and efficiently while collaborating remotely with internal teams.

What You’ll Need:

• Active, unrestricted Registered Nurse (RN) license
• 2+ years of acute care nursing experience — ICU or ER strongly preferred
• (Note: Experience limited to NICU, OB, Behavioral Health, or Substance Abuse may not meet criteria)
• Proficiency in InterQual, MCG, or similar utilization review tools (preferred but not required)
• Advanced computer skills with a minimum of 40+ WPM typing speed
• Excellent verbal and written communication and strong organizational skills
• Prior utilization review experience in either an insurance or acute care hospital setting (preferred)

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Contract

Job function

• Job function

  Health Care Provider

• Industries

  Insurance

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