What are the responsibilities and job description for the RN Review Analyst position at BCVS Group?
Position:- RN Review Analyst/Utilization Management
Pay Rate:- $40/hr.
Location:- Fully Remote ( Candidate should reside in Michigan)
Note:- Client is looking for someone who have Med surg/Discharge planning, SNF, Hospice Experience.
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.
Requirements:
- 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 .
- Certification in Case Management may be preferred based upon designated department assignment
Job Type: Contract
Pay: From $40.00 per hour
Expected hours: 40 per week
Schedule:
- 8 hour shift
Experience:
- Clinical care: 3 years (Required)
- Medsurg/Discharge Planning/SNF/Hospice: 1 year (Required)
- Utilization review: 1 year (Preferred)
License/Certification:
- Michigan License (Required)
Work Location: Remote
Salary : $40
