Job Description

Job Title: Registered Nurse-Review Analysis
Duration: 12 months contract 
Schedule: Remote
Pay Rate: up to 42/HR

• Registered Nurse with current unrestricted Michigan Registered Nurse license required.

• One (1) year of health insurance plan experience or managed care environment preferred.

Job Summary:

Perform prospective, concurrent, and retrospective reviews 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.

Education and Qualifications:

• Bachelor’s 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 related to patient care and health care delivery processes.
• One (1) year of 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.

“Beware of scams. S3 never asks for money during its onboarding process.”