Job Description

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!

Strategic Staffing Solutions is currently looking for an RN Review Analyst for a contract opportunity with one of our largest clients located in Detroit, MI!

Title: RN Review Analyst (Medical Policy Specialist)
Location: Detroit, MI or Grand Rapids, MI (mostly remote; 1 day per week onsite at either location)
Duration: 12+ Months
Role Type: W2 Contract Engagement
Max Rate: 40/HR

Engagement Description

We are seeking a highly skilled and experienced Registered Nurse (RN) to join our team as a Medical Policy Specialist. As a key member of our team, you will play a critical role in reviewing and maintaining our medical policies and procedures to ensure they are grounded in scientific evidence, aligned with professional guidelines, and compliant with CMS regulations. Your expertise will help us uphold our organization's mission and goals, while also supporting our commitment to delivering high-quality patient care.  This position will include responding to questions from internal stakeholders on medical policy and coding matters. 

Top 3 Required Skills/Experience

• Policy development and analysis experience: The ideal candidate should have experience in developing, analyzing, and interpreting medical policies, procedures, and guidelines. They should be able to identify areas for improvement and update policies accordingly.
• Medical knowledge and background: A strong foundation in medical terminology, medical coding and billing, CMS Medicare regulations, and clinical practices are necessary.
• Health Insurance experience: Must have Medicare Advantage experience working for a health insurance provider. Utilization Management experience is a plus.

Required Skills/Experience

• Strong writing and communication skills
• Research and analytical skills
• Attention to detail and organizational skills: Medical policy writers must be meticulous and organized, with the ability to manage multiple projects and deadlines.

Preferred Skills/Experience

• Proficiency in Microsoft Office, particularly Word, and experience with content management systems, document management software, or other relevant tools are necessary.
• Work effectively with various stakeholders, including healthcare professionals, administrators, and other subject matter experts, to gather input and feedback on policies.
• Prepare and format documents according to industry standards, journal guidelines, and client specifications, including manuscript formatting, reference formatting, and document styling, to facilitate submission and publication.
• Review and revise draft documents for content accuracy, clarity, coherence, and consistency, incorporating feedback from subject matter experts, project stakeholders, and regulatory reviewers to ensure document quality and compliance with requirements.

Education/Certifications

• Bachelor’s degree in nursing minimum, prefer Master’s in Nursing or related field
• Current RN Licensure

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