Employment Type:

Shift:

Description:

Position Summary:

Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to payors
ensuring proper reimbursement for care. In collaboration with members of the health care team, conducts 
observation, admission, concurrent, discharge and retrospective reviews to evaluate the appropriate level of care, 
continued stay, and status of discharge planning.

What you will work:

• Full time
• 40 hours per week
• 11:00 PM - 7:30 AM
• Remote

What you will do:

• Perform all aspects of utilization review to ensure the medical necessity of acute care hospitalization has the existence of supportive documentation in the EMR
• Provide all external review organizations the information necessary to complete reviews and effect maximum financial reimbursement
• Collaborate with Case Management
• Provides consultation and information to physicians, case managers and other members of the health care team

What you will need:

• Bachelor of Science in Nursing (BSN)
• Current State of Michigan Registered Nurse License
• Three years acute care as a RN
• Preferred: Two years recent acute care utilization management experience, experience in facility audits/appears and processes
• Ability to work autonomously with little direction and be accountable for outcomes

What you will work:

• Full time
• 40 hours per week
• Night shift

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.