RN-Clinical Review Analyst

Fully remote
- Must have state of MI unrestricted RN license.

You will 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

Important

QUALIFICATIONS:

• Above average computer skills (Microsoft office)
• Clinical experience in ICU, ER, or medical surgical unit preferred
• Prefer utilization management experience

Additional Qualifications:

• Two (2) to three (3) 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

Education/Certification:

• Bachelor's degree in nursing
  , allied health, business, or related field preferred
• Registered Nurse with current unrestricted Michigan Registered Nurse license required

Why work at G-Tech?

G-Tech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at G-Tech, 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.

G-Tech 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.