Registered Nurse RN Case Manager and Review Analyst-Rn

Conduct utilization review and medical necessity assessments. Review clinical documentation for appropriateness of care and services. Coordinate care across providers, facilities, and healthcare teams. Support discharge planning and transitions of care. Identify gaps in care and recommend interventions. Maintain accurate and timely documentation. Collaborate with interdisciplinary teams to improve quality outcomes. Analyze clinical records and healthcare data to support decision-making. Requirements include active, unrestricted RN license, residence in Michigan, minimum 2 years of Case Management, Utilization Review, Utilization Management, or Care Coordination experience, strong clinical assessment and critical thinking skills, proficiency with electronic medical records, excellent communication skills, and ability to work independently remotely. Preferred qualifications include CCM certification, experience with Medicare/Medicaid/Commercial Health Plans, prior experience in Utilization Management, and BSN.