Job description:
• *MUST HAVE A MICHIGAN NURSING LICENSE**
• *MUST LIVE IN MICHIGAN**
Registered Nurse - Utilization Review
OpTech is recruiting RN Case Managers for a tier-1 client.
This is a telephonic/remote role. Are you a hard worker? Do you learn fast? Are you ready to step away from the bedside? This is a great role for you! Are you ready to work no weekends? No holidays?
JOB PERKS:
• Monday - Friday full time schedule with no weekends or holidays
• Opportunity to step away from bedside and explore a new side to nursing
• Work Life Balance
Job Responsibilities:
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.
Requirements:
· RN - unrestricted Michigan Registered Nurse license required
· 2-4 years of clinical experience - acute patient care, discharge planning, case management, and utilization review
· Clinical experience in ICU, ER, or medical surgical unit preferred.
· Utilization management experience preferred
· 1 year health insurance plan experience or managed care environment preferred.
· Above average Computer skills - MS Office, Type 35+WPM, Dual monitors, multiple systems
· Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.
Pay: $37.00 - $39.00 per hour
Expected hours: 40.0 per week
Benefits:
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance
Education:
• Associate (Required)
Experience:
• Clinical Nursing: 3 years (Required)
• Utilization Review: 2 years (Required)
• Case Management: 1 year (Preferred)
• ICU, ER, Med Surg: 1 year (Preferred)
Work Location: Remote