RN: Utilization Review

Grand Rapids, MI 49525

Posted: 03/11/2019 Job Number: 25639

Full time Utilization Review- RN openings in the Grand Rapids, MI area with a major healthcare company! Working Remotely Opportunities!

Starting ASAP! Apply now to Bryan Roy with A-Line!

HOURS: 40 hours per week. 8- hr shift between 8am - 5pm, Monday through Friday

Job Description
  • Provides health information, interacts and acts as a resource for nursing units for complex clinical situations to ensure appropriate use of acute care services and diagnosis-related group (DRG) management.
  • Assesses appropriateness of inpatient admissions and continued stay.
  • Educates medical staff/other health care professionals regarding utilization management and quality requirements.
  • Makes recommendations and provides financial and utilization management (UM) information to other members of the care facilitation teams for work prioritization.
  • Works closely with inpatient care facilitators and Medical Social Workers to move patients through the continuum appropriately.

  • Utilization Review nurse needed at Priority Health for a 6 month to 1 year assignment.
  • Experience in UM is required as well as competence in InterQual Criteria.
  • FACETS and Vital Systems can be taught.
  • The nurse will need to be onsite for initial training but can work remotely once they demonstrate proficiency

Why Apply:
  • Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability
  • 401k after 1 year of employment: With employer match and profit sharing
  • Wellness Program: Now including FITNESS benefits!
  • GREAT Hours! Monday through Friday, 40 hours per week, No Weekends
  • Competitive Pay Rate!

Apply now to Bryan Roy with A-Line!


(586) 323-6600


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