RN Clinical Grievance Analyst

Strategic Staffing Solutions; Detroit (MI); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading company is seeking an RN Clinical Grievance Analyst for a 12-month contract in Detroit, MI. The role involves analyzing grievances, documenting findings, and providing clinical support to ensure resolution. Candidates must be a registered nurse in Michigan with a strong background in clinical documentation and benefit policies.

Qualifications

• Registered Nurse with current Michigan license required.
• 2-5 years clinical patient care experience.
• Expertise in use of medical terminology and clinical documentation preferred.

Responsibilities

• Provide clinical support to grievances; analyze and resolve complaints.
• Document findings within the system for claim adjudication.
• Assist in constructing write-ups for evaluations if decisions cannot be concluded.

Skills

Grievance and Appeals Experience

Knowledge of Benefit Policies

Medical Terminology

Clinical Documentation

Strong Computer Skills

Education

Associate Degree in Nursing

Nursing Diploma

BSN (Preferred)

Job description

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!

Strategic Staffing Solutions is currently looking for an RN Clinical Grievance Analyst for a contract opportunity with one of our largest clients located in Detroit, MI!

Title: RN Clinical Grievance Analyst
Location: Detroit, MI (Remote – must be local to Michigan)
Duration: 12+ Months
Role Type: W2 Contract Engagement
Max Rate: 36/HR

Must have:

• Previous experience with Grievance and Appeals
• Knowledge of Benefit policies/guidelines
• Medical terminology
• Clinical documentation
• Interqual experience a bonus
• Must have strong Computer Skills
• Registered Nurse with current Michigan license required.

Job Description:
Provide Clinical support to all grievances. Analyze, investigate, resolve and respond to highly confidential/sensitive inquiries and complaints received through the formal member grievance process. Responsible for rendering a decision documenting findings within the system and advising the findings to allow for claim adjudication. If a decision can’t be concluded or the findings result in a denial the RN Review Analyst will be instrumental in constructing a write up that is required for evaluation; describing the current findings along with the supporting documentation for medical consultant analysis.

Requirements:

• Registered Nurse with current Michigan license required.
• Associate Degree in Nursing or Nursing diploma required. BSN preferred.
• Two-five (2-5) years clinical patient care experience; can include LPN and RN patient care combined.
• Med/Surg, acute care, home care and/or rehabilitation clinical experience.
• Expertise in the use of medical terminology and clinical documentation preferred.
• MDS, case management and utilization review experience highly beneficial.
• Good computer and multi-task abilities; able to navigate through data entry systems.
• Must have knowledge of Medicare Benefit Policy, medical terminology with some medical coding highly helpful.
• Ability to navigate between screens for inputting and pulling data is required.
• Able to type between 25-30WPM or greater.

*Beware of scams. S3 never asks for money during its onboarding process

Job ID: JOB-241579
Publish Date: 13 Jun 2025

Tagged as: RN Clinical Grievance Analyst