Registered Nurse-Review Analys

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Registered Nurse-Review Analys

By / September 2, 2026

• Location: Detroit, Michigan
• Type: Contract
• Job #106555

Review Analyst-Registered Nurse

Location:

Remote but looking for candidates in MI-MUST HAVE A MI NURSING LICENSE

Schedule:

Monday-Friday

Type:

W2 Contract

Duration:

Long term on-going contract

Pay Rate:

$36-$39 an hour

Work Location

• Remote position

• Contractor will be required to come onsite for one day of training to:

• Receive their company laptop

• Attend in-person onboarding/training

• Note: Onsite requirements could change in the future if directed by executive leadership.

Position Summary

Responsible for performing prospective, concurrent, and retrospective utilization reviews of inpatient, outpatient, ambulatory, and ancillary services to ensure:

• Medical necessity
• Appropriate length of stay
• Intensity of service
• Appropriate level of care

Additional responsibilities include:

• Reviewing appeal requests submitted by providers, facilities, and members
• Developing care plans as needed
• Coordinating care across the healthcare continuum
• Conducting member outreach and assessments

Required Qualifications

• Registered Nurse (RN) with a current, unrestricted Michigan RN license

• 2 to 4 years of clinical experience, which may include:

• Acute patient care

• Discharge planning

• Case management

• Utilization review

• Strong clinical knowledge of patient care and healthcare delivery processes

• Above-average computer skills, including Microsoft Office

Preferred Qualifications

• Bachelor's degree in Nursing, Allied Health, Business, or a related field

• 1+ year of experience in a health insurance plan or managed care environment

• Clinical experience in:

• Intensive Care Unit (ICU)

• Emergency Room (ER)

• Medical-Surgical Unit

• Prior utilization management experience

• Case Management Certification (depending on department assignment)

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