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Apply at resume.mi@mhplan.com

Position Title:  Nurse Reviewer Specialist
Open Positions:  1
Position Requirements: Full Time Position

This position functions collaboratively with the members of the Utilization Management team, specifically with the review nurses and case managers to ensure for timely disposition of inpatient authorization requests and discharge planning activities.

Responsibilities Include:         

Current license (without restriction) to practice as a Licensed Practical Nurse or Registered Nurse in the State of Michigan is required. A minimum of one year customer service experience is preferred. Up to three years clinical experience is preferred. Prior experience as a Utilization Management Specialist or related health industry experience is preferred. Knowledge of managed care and Michigan Medicaid guidelines is preferred. Thorough knowledge of the authorization process is preferred. Understanding of NCQA, URAC or general accreditation requirements for Utilization Management and Appeals is preferred.

Position Reports To:  Manager of Clinical Services