RN Review Analyst

Employer
Compu-Vision Consulting Inc.
Location
Chicago, Illinois
Salary
Negotiable
Posted
Apr 03, 2024
Closes
Apr 08, 2024
Ref
2743348669
Role Type
Administration
Position Type
Analyst
Hours
Full Time
Practice Setting
Ambulatory Care / Outpatient
Work Mode
Remote
Employment Type
Permanent
Organization Type
Government
Job Title: RN Review Analyst
Job ID: BCR

Location: remote

Local to Michigan State Only


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RN Review Analyst
This position will be remote. Resource will be able to perform this role offsite. May be required to come into the office for meetings and training.

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.
  • Above average computer skills (Microsoft office). Clinical experience in ICU, ER, or medical surgical unit preferred. Prefer utilization management experience.