Registered Nurse – Review Analyst

Engagement Description - A brief description of the project or initiative. Include:
1. Project objective(s), work products, resource responsibilities
Responsible for the approval or rejection of Medicare Advantage claims and/or benefit interpretation. Will be required to enter or reference data via PC and/or CRT terminal. Other related skills may be required to perform this job.

Top 3 Required Skills/Experience – The most important must-have skills. Include:
2. Quantified years of experience tied to specific skills/experience, hard skills only (no soft skills like “team player” or “good communicator”)
1. Registered Nurse with current Michigan Registered Nurse License.
2. Associate Degree or nursing diploma required, Bachelor’s Degree in nursing preferred.
3. Exceptional verbal and written communication skills are required for this work.

Required Skills/Experience – The rest of the required skills/experience. Include:
3. Skills/experience ordered from most important (first) to least important (last)
4. Hard and soft skills
5. No more than 10-12 total.
1. Registered Nurse with current Michigan Registered Nurse License.
2. Associate Degree or nursing diploma required, Bachelor’s Degree preferred.
3. Two (2) years RN patient care experience Triage, case management and/or rehabilitation experience preferred.
4. Expertise in the use of medical terminology.
5. Finely honed critical thinking skills are a must.
6. Exceptional verbal and written communication skills are required for this work.

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

• Skills/experience ordered from most important (first) to least important (last)
• No more than 4-5 total

1. Knowledge of CPT/HCPCS coding and Medicare regulations desirable

Education/Certifications – Include:
1. Registered Nurse with current Michigan Registered Nurse License is required.
2. Associate Degree or nursing diploma required, Bachelor’s Degree in nursing is preferred

Job Type: Contract

Pay: $35.00 - $40.00 per hour

Expected hours: 40 per week

Medical specialties:

• Cardiology
• Cath Lab
• Critical & Intensive Care
• Emergency Medicine
• Home Health
• Medical-Surgical
• Pediatrics
• Perioperative Care
• Surgery
• Telemetry

Physical setting:

• Acute care
• Clinic
• Inpatient
• Long term care
• Nursing home
• Outpatient
• Rehabilitation center

Standard shift:

• Day shift

Weekly schedule:

• Monday to Friday

License/Certification:

• RN (Required)

Work Location: In person