Utilization Review Nurse I - (12-75)
Location: Saginaw Michigan
Description: HealthPlus of Michigan is currently interviewing Utilization Review Nurse I - (12-75) right now, this vacancy will be placed in Michigan. Detailed specification about this vacancy opportunity please read the description below. HealthPlus of Michigan has an excellent opportunity for an individual to join our leading health insurance organization. The Utilization Review I(UR) Nurse ensures services meet member's health needs and promotes the provision of high quality care in the most appropriate and cost-effective setting by identifying, assessing, planning, coordinating, monitoring, and evaluating healthcare services, outcomes, and managing the utilization of HealthPlus benefits through activities of medical utilization review and discharge planning. This individual promotes collaboration with the patient care team, such as the Outpatient Case Management team, to ensure a high quality of patient care, reduced length of stay, efficient utilization of resources, and appropriate reimbursement of care and services, including discharge planning assistance and aftercare support. Time may be split between project work and performing clinical reviews. HealthPlus of Michigan offers a comprehensive benefit package including medical, dental, vision and life insurance. We also offer a 401(k) with employer-matching contributions. Qualified applicants please submit a cover letter that states this position along with a resume. HealthPlus is an Equal Opportunity Employer. Qualified minorities, women, people with disabilities, and military veterans are encouraged to apply.
The qualified Candidate should have two (2) years Utilization Management and/or Hospital discharge planning in the acute care setting within the past four (4) years. Four (4) years hospital clinical experience of medical, surgical, orthopedic neuro-surgery or pediatric nursing. Demonstrated knowledge of the InterQualR or Milliman Care GuidelinesR criteria with use within the past four (4) years. A current, valid Michigan license to practice as a Registered Nurse without anyconditions, limitations or restrictions.*CB*
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to HealthPlus of Michigan.
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This vacancy starts available on: Wed, 08 Aug 2012 13:08:11 GMT