Job Description

• This position will be remote role for Nurses in Michigan
• Should have a valid MI RN License
• Should Have utilization management experience.
• Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing facility settings previously.
• The candidate should be well versed in coordination of care activities along with discharge planning which is a plus for this role in ensuring members are transitioned safely following care.
• In addition, the candidate should have knowledge of post-acute InterQual criteria that is utilized in this role.

• Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.
• One 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.
• Above average computer skills
• Clinical experience in ICU, ER, or medical surgical unit preferred.

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