Registered Nurse - Review Analyst

UM Program is provider focused requiring professional interaction with Acute Inpatient Hospital/Post-Acute Care clinical staff and physicians. Program is not member/patient facing.

Goal of UM Program is to ensure member is in the most appropriate setting based on severity of their illness and intensity of services being provided in the inpatient setting.

Role for clinical Registered Nurse requires review of clinical documentation provided by the facility, application of InterQual criteria, and ability to professionally interact (written, telephonic and verbal) with clinical staff internally and externally. Role does not involve review of claims.

Requirements:
-2 years acute care experience with an unrestricted Registered Nurse license in Michigan.
- ICU/ER preferred *should not just be 2 years in a specialized field such as NICU/OB/BH/Substance Abuse *
-InterQual/MCG or other utilization review experience
-Advanced computer skills
-40+ WPM typing
-MI residence