Address
Form of workJob Description
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 coverage plans that include individual and family, dental and vision, plans for employers, etc.
Title: Registered Nurse-Review Analys
Work Location: Detroit, MI 48243
Duration: 10 Months
Job Type: Contract
Work Type: Remote
Dept: Commercial Inpatient Pr
ENGAGEMENT DESCRIPTION:
- Responsible for the review of precertification admission and concurrent reviews for the appropriateness of the inpatient setting utilizing InterQual criteria.
- Required to enter or reference data via PC, collaborate with facilities, providers and Medical Directors.
- Must have excellent written and oral communication skills.
- Other related skills may be required to perform this job.
- 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.
Requirements:
- Registered Nurse with current Michigan driver's license.
- Associate Degree or nursing diploma required.
- Two (2) years patient care experience.
- Triage, case management or utilization review experience.
- Expertise in the use of medical terminology.
- InterQual knowledge preferred.
- Some weekends and corporate holidays.
Top 3 Required Skills/Experience:
- 2 years acute care experience with an unrestricted Registered Nurse license
- ICU/ER preferred or for post-acute care positions SNF/Rehab/LTACH) should not just be 2 years in a specialized field such as NICU/OB/BH/Substance Abuse
- InterQual/MCG or other utilization review experience
Required Skills/Experience The rest of the required skills/experience. Include:
- Advanced computer skills
- 40+ WPM typing
TekWissen Group is an equal opportunity employer supporting workforce diversity.
