Engagement Description –

Perform prospective, concurrent and retrospective review of inpatient services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers and facilities

Top 3 Required Skills/Experience –

• Bachelor’s degree in nursing preferred

• 2-4 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.

• Registered Nurse with current unrestricted Michigan Registered Nurse license required.

Required Skills/Experience – The rest of the required skills/experience. Include:

• Above average computer skills (Microsoft office).

• Clinical experience in ICU, ER, or medical surgical unit preferred

Preferred Skills/Experience – Optional but preferred skills/experience. Include:

• 1 year health insurance plan experience or managed care environment preferred

Education/Certifications – Include:

• Bachelor’s degree in nursing preferred.

• Registered Nurse with current unrestricted Michigan Registered Nurse license required

• 1 year health insurance plan experience or managed care environment preferred.

Category Benefits

Function HR / Benefits

Req ID JN -102024-121665