Utilization Review Nurse

w3r Consulting; Detroit (MI); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a detail-oriented Registered Nurse – Review Analyst for an exciting 8-month remote contract. This role demands clinical judgment and strong communication skills to ensure effective care decisions. The ideal candidate will have a minimum of 2 years of acute care experience and a current RN license. You'll engage in reviewing precertifications and admission approvals, making a significant impact in the healthcare field. If you're ready to take on a challenging yet rewarding role in a supportive environment, this opportunity is perfect for you.

Qualifications

• 2+ years of acute care experience required.
• Strong communication and organizational skills needed.

Responsibilities

• Review precertifications and admission approvals.
• Perform telephone triage and benefit interpretation.

Skills

Acute Care Experience

Registered Nurse License

ICU or ER Experience

Computer Proficiency

Typing Speed (40+ WPM)

Verbal and Written Communication

Organizational and Multitasking Skills

Education

Current, Unrestricted Registered Nurse (RN) License

Tools

InterQual

MCG

Job description

Direct message the job poster from w3r Consulting

Service Delivery Manager @ TalentRupt Inc. | Staffing Operations

Job Title: Registered Nurse – Review Analyst

Contract Duration: 8 Months

Location: Detroit, MI (Remote)

Job Type: Contract

Engagement Overview:

We are seeking an experienced and detail-oriented Registered Nurse – Review Analyst for an 8-month remote contract based in Detroit, MI. The selected candidate will be responsible for the review of precertifications, admission approvals, telephone triage, and benefit interpretation. This role requires clinical judgment, attention to detail, and strong communication skills to ensure appropriate care decisions are made. Data entry and interaction with clinical guidelines and internal systems are essential aspects of this role.

Top 3 Required Skills/Experience:

• Minimum 2 years of acute care experience with an unrestricted Registered Nurse license

Experience should not be limited to specialized areas such as NICU, OB, BH, or Substance Abuse

• ICU or ER experience strongly preferred
• Familiarity with InterQual, MCG, or other utilization review criteria/tools

Required Skills/Experience:

• Advanced computer proficiency
• Typing speed of 40+ WPM
• Strong verbal and written communication abilities
• Excellent organizational and multitasking skills

Preferred Skills/Experience:

• Previous Utilization Review experience with a health insurance company (medical or surgical admissions)
• Utilization Review experience within an acute care setting

Education and Certifications:

• Must hold a current, unrestricted Registered Nurse (RN) license in the United States

Seniority level

• Mid-Senior level

Employment type

• Contract

Job function

• Health Care Provider

Industries

• Hospitals and Health Care

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