Registered Nurse-Review Analys

Overview:

TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care covera

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 client Registered Nurse license required.
• Certification in Case Management may be preferred based upon designated department assignment.

Requested criteria:

• Above average computer skills (Microsoft office). Clinical experience in ICU, ER, or medical surgical unit preferred.
• Prefer utilization management experience.
• May be required to come into the office for meetings and training.

TekWissen® Group is an equal opportunity employer supporting workforce diversity.

Job Types: Full-time, Contract

Pay: $33.00 - $35.00 per hour

Application Question(s):

• Michigan Nursing License?

Experience:

• Clinical experience in ICU, ER, or medical surgical unit: 2 years (Preferred)

Ability to Relocate:

• Tennessee: Relocate before starting work (Required)

Work Location: In person