Utilization Review Nurse Job at w3r Consulting, Detroit, MI

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  • w3r Consulting
  • Detroit, MI

Job Description

Job Description

Job Title: Registered Nurse – Review Analyst

Duration: 12 Months (Contract)

Location: Detroit, MI (Remote bust must reside near Detroit, Michigan)

Engagement Description:

The RN Review Analyst is responsible for processing inpatient admission requests using InterQual criteria to determine the medical necessity of an inpatient status. This role involves completing admission approvals and denials (as per physician decision), conducting telephone triage, and interpreting benefits. The RN Review Analyst plays a key role in ensuring appropriate utilization of healthcare resources.

Onsite Requirement:

This position is primarily remote; however, if there are technical issues with equipment, the employee may be required to work onsite or visit the office for computer repairs.

Top 3 Required Skills/Experience:

  • Current Registered Nurse license with a valid Michigan driver’s license.
  • Associate Degree in Nursing or a nursing diploma.
  • 2 to 4 years of direct patient care experience, which may include acute patient care, discharge planning, case management, or utilization review.

Additional Required Skills/Experience:

  • Proficient in medical terminology.
  • Comfortable using Microsoft Office Suite, including Teams.

Preferred Skills/Experience:

  • Post-acute patient care experience.
  • Experience in triage, case management, or utilization review.
  • Working knowledge of InterQual criteria.
  • Experience with Clinical Care Advance software.

Education/Certifications:

  • Associate’s Degree or Nursing Diploma required.

w3r Consulting

Job Tags

Contract work,

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