Registered Nurse-Review Analys
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Job Location:
Detroit, MI - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Overview:
TekWissen is a global workforce management provider headquartered in Ann Arbor Michigan that offers strategic talent solutions to our clients world-wide. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family dental and vision plans for employers etc.
Title: Registered Nurse-Review Analys
Work Location: Detroit MI48226
Duration: 2 Months
Job Type: Temporary Assignment
Work Type: Remote
Dept: Medicare Pharmacy Quality
Engagement Description
- Perform prospective concurrent and retrospective review of inpatient outpatient ambulatory and ancillary services to ensure medical necessity appropriate length of stay intensity of service and level of care including appeal requests initiated by providers facilities and members.
- May establish care plans and coordinate care through the health care continuum including member outreach assessments.
- Bachelors degree in nursing allied health business or related field preferred.
- Two (2) to four (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.
- One (1) year health insurance plan experience or managed care environment preferred.
- Registered Nurse with current unrestricted Michigan Registered Nurse license required.
- Certification in Case Management may be preferred based upon designated department assignment.
TekWissen Group is an equal opportunity employer supporting workforce diversity.
Key Skills
- EMR Systems
- Hospital Experience
- Acute Care
- ICU Experience
- Hospice Care
- Workers' Compensation Law
- Home Care
- Nursing
- Catheterization
- Critical Care Experience
- Medication Administration
- Tube Feeding
