RN Review Analyst – Pre/Post Admission Review Employment Opportunity ---- REMOTE
Location:
Remote (Must reside in Michigan)
Position Type:
Full-Time (40 hours/week)
Schedule:
Monday – Friday (No weekends, no holidays)
Pay Rate:
$37.00 – $39.00 / hour
About the Role
Are you a dedicated Registered Nurse looking to transition away from direct bedside care while continuing to make a vital impact on patient outcomes? OpTech is seeking an
experienced RN Review Analyst for a telephonic/remote role with a top-tier healthcare client.
If you are a fast learner with strong clinical judgment and a desire for predictable hours and excellent work-life balance, this is the perfect next step in your nursing career.
Job Perks
Work-Life Balance:
Standard Monday through Friday schedule with
no weekends and no holidays
.
Career Growth:
Step away from bedside nursing and expand your expertise in managed care and utilization review.
100% Remote Flexibility:
Work comfortably from your home office in Michigan.
Key Responsibilities
Perform prospective, concurrent, and retrospective reviews for inpatient, outpatient, ambulatory, and ancillary services.
Evaluate medical necessity, appropriate length of stay, intensity of service, and level of care.
Handle review appeal requests initiated by providers, healthcare facilities, and plan members.
Establish care plans and coordinate care across the healthcare continuum, including direct member outreach and clinical assessments.
Qualifications & Requirements
Mandatory Requirements:
Education:
Associate Degree in Nursing (ADN) required; BSN preferred.
Licensure:
Active, unrestricted
Michigan Registered Nurse (RN) License
(Required).
Residency:
Must currently reside in the state of
Michigan
.
Clinical Experience: Minimum of 2–4 years of RECENT clinical experience in acute patient care (ICU, Emergency Room, or Medical/Surgical unit required by hiring manager).
Preferred Experience:
2+ years of experience in Utilization Review / Utilization Management.
1+ year of experience in Case Management or discharge planning.
1+ year of experience working within a health insurance plan or managed care environment.
Technical Skills & Competencies:
Strong computer proficiency, including experience with MS Office Suite, multi-system navigation, dual-monitor setups, and typing speed of 35+ WPM.
Thorough understanding of clinical knowledge, patient care processes, and healthcare delivery systems.
Strong decision-making, critical thinking, and communication skills.
Benefits
Health Insurance
Dental Insurance
Vision Insurance
Paid Time Off (PTO)
Why work at OpTech?
OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at OpTech, not only do you get health and dental benefits, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today!
By submitting your application, you acknowledge that recruiting technologies, including AI-assisted tools, may be used to support candidate evaluation, sourcing, matching, and communications.
OpTech is an Equal Opportunity Employer (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.