RN Care Review Clinician - Utilization Management Expert

Healthcare Support Staffing; Troy (MI); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive salary, negotiable based on experience

Acquire new skills

Positive work environment

Job summary

A healthcare staffing firm is seeking an experienced Registered Nurse in Michigan to provide utilization review for healthcare services. Candidates should possess a valid RN license and experience in both utilization review and Interqual. This opportunity offers a competitive salary, supportive work environment, and the chance to acquire new skills. If you are looking to advance your career, this role may be ideal for you.

Qualifications

• At least one year of experience in a Managed Care or Provider environment.
• Registered Nurse License in Michigan is required.
• Experience with Interqual for a minimum of one year.
• 2-4 years of clinical practice is preferred.

Responsibilities

• Conduct concurrent review and prior authorizations according to Molina policy.
• Identify benefits, eligibility, and length of stay for treatments.
• Provide utilization review for Medicaid and Medicare services.

Skills

Utilization Review background

RN License in Michigan

Interqual experience

Clinical practice experience

Job description

A healthcare staffing firm is seeking an experienced Registered Nurse in Michigan to provide utilization review for healthcare services. Candidates should possess a valid RN license and experience in both utilization review and Interqual. This opportunity offers a competitive salary, supportive work environment, and the chance to acquire new skills. If you are looking to advance your career, this role may be ideal for you.