RN Precertification Analyst

RN Precertification Analyst

Detroit

• MI

Registered Nurse (RN)

Contract

We are seeking a Michigan RN for a remote position in Utilization Management

Engagement Description:

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 members are 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.

Top 3 Required Skills/Experience -

• 2 years of acute care experience with an unrestricted Registered Nurse license.
• InterQual/MCG or other utilization review experience.
• Advanced computer skills with strong understanding of Microsoft platforms and ability to navigate multiple programs.

Required Skills/Experience - The rest of the required skills/experience. Include:

• ICU/ER, Utilization Management preferred should not just be 2 years in a specialized field such as NICU/OB/BH/Substance Abuse
• 40+ WPM typing
• Strong reading comprehension skills

Preferred Skills/Experience - Optional but preferred skills/experience. Include:

• Strong organizational skills
• Good verbal and written communication skills
• Experience in training, power point, policy and job aid development

Education/Certifications - Include:

• Highest level of nursing education
• Additional Certifications

Why work with us? We are a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work with us you'll have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! We are an EOE, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. https://www.optechus.com/eeo_self_identification/

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