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Job Description
Join Detroit Medical Center as a Registered Nurse in Utilization Review, where you'll play a crucial role in optimizing patient care through effective resource coordination and management of medical necessity processes.
Key Responsibilities
Facilitate effective resource coordination for optimal patient health
Manage medical necessity process for payment accuracy
Coordinate with payors for appropriate level of care
Educate stakeholders on covered services and compliance
Document authorization and manage concurrent disputes
Required Qualifications
Active and valid RN license
At least two years acute hospital or Behavioral Health patient care experience
Preferred Qualifications
BSN
One year hospital acute or behavioral health case management experience