Registered Nurse-Review Analyst

SriMatrix health; Detroit (MI); Hybrid; USD 41,328 - 46,838; Part time

Job summary

Srimatrix Health in Detroit, MI is seeking a Registered Nurse-Review Analyst on a 10-month contract. The hybrid role requires one day on-site weekly and pays $30-$34 per hour on W2.

The RN must hold a Michigan license and will develop and maintain Medicare Medical Policies, collaborating with Medical Director and committees; strong writing and organizational skills are essential. Experience with CPT/HCPCS codes and CMS guidance is preferred; duties include research and policy documentation to

Qualifications

• Experience in Medicare and managed care health insurance medical policy.
• Strong written communication and ability to write clear documents.
• Experience with collaborative projects.

Responsibilities

• Develop and maintain Medicare Medical Policies with annual reviews/updates.
• Collaborate with Medical Director on policy development and maintenance.
• Review commercial medical policy meeting minutes to update Medicare policies.
• Prepare policies and documents for Criteria Review Committee and Utilization Management Committee Meetings.
• Research CPT or HCPCS codes as needed.
• Research medical technologies as needed for authorizations.
• Familiar with Microsoft Office products.
• Respond to inquiries from other teams.

Skills

Medicare policy experience

Written communication

Collaborative projects

CPT/HCPCS knowledge

Clinical experience

Microsoft Office

Education

RN license (Michigan)

Tools

Microsoft Office

Job description

Registered Nurse-Review Analyst

Location: Detroit, MI, 48226

Duration: 10 Months

Job Type: Contract

Work Type: Hybrid (one day a week)

Dept: Medicare Medical Policy

Pay: $30-$34 per Hour on W2

At Srimatrix Health, we're dedicated to connecting talents with opportunities that transform lives.

Registered nurse with current unrestricted Michigan Registered Nurse license required.

Job Responsibilities

• Develop and maintain Medicare Medical Policies ensuring policies are approved, implemented, and placed in repository, including annual reviews/updates
• Collaboration with Medical Director on medical policy development and maintenance
• Assist with the review of commercial medical policy meeting minutes to update Medicare Policies where needed
• Supporting the preparation of policies and documents for Criteria Review Commitee and Utilization Management Committee Meetings
• Research CPT or HCPCS codes as needed
• Researching medical technologies as needed for specific cases requesting authorizations on technologies
• Familiar with Microsoft Office products
• Respond to inquiries from other teams.

Top 3 Required Skills/Experience

• Experience in Medicare and managed care health insurance medical policy.
• Strong written communication skills: ability to write clear and concise documents
• Experience with collaborative projects

Required Skills

• Research, gather, plan, organize and evaluate information from multiple sources
• Knowledge of CPT and HCPCS codes
• Critical thinking and problem-solving skills
• Clinical experience
• Familiar with Microsoft Office products

Preferred Skills

• Experience with medical Billing/Coding
• Knowledge of CMS Medicare coverage guidance
• Experience in maintaining a repository of documents.
• Registered nurse with 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.
• One (1) year health insurance plan experience or managed care environment preferred.