RN Review Analyst (Local Michigan Licensed) - InterQual experience

Job Description

Job Description

Job Title : RN Review Analyst

Duration : 9 months to begin with

Will this position be required to work onsite for any reason at any time? YES, for in person training / pick up their laptop for one day during training. Otherwise, this would not require onsite presence unless required during training. As everything else here, that can change if we are given a specific directive from executive leadership.

Job description :

Perform prospective, concurrent and retrospective review 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. 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 relative to patient care and health care delivery processes.

One (1) year 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.

Requested criteria :

2 years acute care experience with an unrestricted Registered Nurse license, ICU / ER preferred or for post-acute care positions SNF / Rehab / LTACH (Should not just be 2 years in a specialized field,)

InterQual / MCG or other utilization review experience, advanced computer skills, 40+ WPM typing

Company Description

Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.

At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.

Kyyba is an Equal Opportunity Employer.

Kyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b

Company Description

Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.\r\n\r\nAt Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.\r\n\r\nKyyba is an Equal Opportunity Employer.\r\n\r\nKyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b