Remote UR/LTSS RN - Utilization Review Specialist

Michigan Peer Review Organization

Michigan

Hybrid

USD 50,000 - 58,000

Full time

9 days ago

A complete application in a minute

Tailored resume and cover letter, ready to send.

Get past ATS filters

Job summary

iMPROve Health is recruiting a Michigan-licensed Registered Nurse (RN) for a contingent, fully remote Utilization Review / LTSS Review Nurse role. The position supports Michigan Medicaid programs, reviews Nursing Facility LOC and Home Help assessments, and requires UR/UM and LTSS experience.

The role offers flexible, contingent hours with normal business hours while occasional evenings or weekends may be needed. Strong documentation and remote collaboration are essential.

Qualifications

Active, unrestricted Michigan RN license required.
Long-Term Care/LTSS experience required.
UR/UM experience required.
Minimum of 3–5 years combined experience in UR/UM and LTSS.
Excellent clinical assessment, analytical, and documentation skills.

Responsibilities

Perform utilization review activities per program requirements and clinical guidelines.
Conduct telephonic LOC reviews for Michigan Medicaid beneficiaries.
Review LTSS cases and perform verification and quality reviews.
Conduct virtual Home Help assessments using Microsoft Teams.
Maintain timely, accurate documentation and communicate findings to providers and staff.

Skills

RN license (MI)

LTSS experience

UR/UM experience

3–5 years experience

strong communication

EHR proficiency

independent remote work

Education

BSN or nursing degree preferred

Equivalent experience considered

Tools

Microsoft Teams

MS Office (Outlook/Word/Excel)

Secure web portals / EHR systems

Job description

The role offers flexible, contingent hours with normal business hours while occasional evenings or weekends may be needed. Strong documentation and remote collaboration are essential.

Get your free, confidential resume review.

or drag and drop your file here.