Nurse

RN Review Analyst

Contract

Strategic Staffing Solutions

STRATEGIC STAFFING SOLUTIONS (S3) HAS AN OPENING!

Strategic Staffing Solutions is currently looking for an RN Review Analyst for a contract opportunity with one of our largest clients located in Detroit, MI!

Title: Registered Nurse Review Analyst

Location: Detroit, MI (initially remote)

Duration: 12+ months

Role Type: W2 Contract position

Hours: M-F 8-5

Role Summary

Responsible for providing clinical and technical support for the assigned area(s).

  • Assist with the design, development, modification, testing, implementation, and maintenance of assigned systems related to medical reviews for claims and inquiries.
  • Assist teams with the resolution of problems, conduct special assignments as requested and populate and interpret reports and/or analysis documenting the results with recommendations to management.
  • Troubleshoot problems, identify defects, trends, procedural practices and submit recommendations.  May be required to interface with other areas, either internally or externally, to resolve problems.
  • Compile and analyze data and produce routine and non-routine reports, presentations, letters, and communications in compliance with local, state, and federal regulations and NCQA accreditation standards.
  • Assist personnel (both internal and external) by answering questions, supplying information and training.
  • Accurately assess health needs in a manner consistent with current nursing standards and practice in order to provide appropriate clinical recommendations.
  • Utilize knowledge of approved resources, programs, products, and tools to provide appropriate review of services and preauthorization’s based on medical necessity.
  • Collaborate with peers and project and team members.
  • Participate in continuous improvement efforts resolving issues that impact operations, business workflows, processes, and strategies.
  • Utilize up-to-date technical skills to navigate through electronic leadership tools and platforms; with the ability to test new tools as required.

Qualifications:

  • Associate degree in Nursing or RN Diploma required.  
  • Two (2) to 3 years of clinical experience including Medical Surgical.
  • Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.
  • Registered Nurse with current unrestricted state of Michigan license required. Excellent written and verbal communication skills.
  • Working knowledge of PC applications. Able to comprehend and use other systems and applications used within the assigned department.
  • Other related skills and/or abilities may be required to perform this job.
  • Work individually and in a diverse team environment.

Departmental Preferences:

  • Bachelor’s Degree preferred.
  • Utilization Review Experience preferred.

 

The S3 Difference

The global mission of S3 is to build trusting relationships and deliver solutions that positively impact our customers, our consultants, and our communities.  The four pillars of our company are to:

  • Set the bar high for what a company should do
  • Create jobs
  • Offer people an opportunity to succeed and change their station in life
  • Improve the communities where we live and work through volunteering and charitable giving

As an S3 employee, you’re eligible for a full benefits package that may include:

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • 401(k) Plan
  • Vacation Package
  • Life & Disability Insurance Plans
  • Flexible Spending Accounts
  • Tuition Reimbursement

Job ID: JOB-208364
Publish Date: 20 Oct 2022

Tagged as: RN Review Analyst