Registered Nurse-Review Analys

TekWissen ®; United States; Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a dedicated Registered Nurse-Review Analyst to join their dynamic team. This role involves performing comprehensive reviews of post-acute care services to ensure medical necessity and appropriate care levels. The ideal candidate will possess a current Michigan Registered Nurse license and have clinical experience in skilled nursing facilities or long-term acute care. This innovative firm offers a remote work environment and values workforce diversity, making it an exciting opportunity for those looking to make a significant impact in health care delivery. If you are passionate about patient care and have a keen eye for detail, this position is perfect for you.

Qualifications

• Registered Nurse with current unrestricted Michigan license required.
• 2-4 years of clinical experience including acute patient care and case management.

Responsibilities

• Perform reviews of post-acute care services to ensure medical necessity.
• Establish care plans and coordinate care through the health care continuum.

Skills

Computer Skills

Clinical Experience in SNF, LTAC or IPR

Utilization Management Experience

Education

Bachelor's Degree in Nursing or Related Field

Michigan Registered Nurse License

Tools

Microsoft Office

Job description

Overview

TekWissen is a global workforce management provider headquartered in Ann Arbor, Michigan that offers strategic talent solutions to our clients world-wide. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc.

Title: Registered Nurse-Review Analyst
Work Location: Detroit, MI, 48243
Duration: 10 Months
Job Type: Contract
Work Type: Remote
Dept: MA Post-Acute Care UM
Job Description

• Perform prospective, concurrent and retrospective review of post-acute care services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members.
• May establish care plans and coordinate care through the health care continuum including member outreach assessments.

Top 3 Required Skills/Experience:

• Above average computer skills (Microsoft office).
• Clinical experience in SNF, LTAC or IPR preferred.
• Prefer utilization management experience.

Required Skills/Experience:

• Registered Nurse with current unrestricted Michigan Registered Nurse license required.
• Two (2) to four (4) years of clinical experience which may include acute patient care, discharge planning, case management, and utilization review, etc.
• Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.

Preferred Skills/Experience:

• Bachelor’s degree in nursing, allied health, business, or related field preferred.
• One (1) year health insurance plan experience or managed care environment preferred.

Education/Certifications:

• Current unrestricted Michigan Registered Nurse license required.

TekWissen Group is an equal opportunity employer supporting workforce diversity.

TekWissen is an emerging global human capital, recruitment and IT services organization. Operating since 2009, we draw upon more than a decade of staffing experience to deliver critical talent acquisition solutions and IT engagements for our clients. We’re founded on a culture that is passionate about delivering tailored solutions, that create lasting partnerships.

Our global footprint covers six countries: United States, Canada, Australia, India, United Kingdom and the Philippines. This allows us to work in close partnership with organizations and manage everything from global talent needs with demanding resourcing strategies, to single sites with lower recruitment volumes.

Seniority level: Entry level

Employment type: Full-time

Job function: Health Care Provider

Industries: IT Services and IT Consulting