Michigan Licensed UR/LTSS Nurse
Job Summary
Seeking a Michigan Licensed UR/LTSS Nurse, the contingent position offers remote work opportunities while conducting Nursing Facility Level of Care reviews and Home Help quality assessments for Michigan Medicaid programs, requiring a minimum availability of 4-8 hours per week.
Key responsibilities
- Perform utilization review activities in accordance with program requirements and clinical guidelines
- Conduct telephonic and virtual assessments for Nursing Facility Level of Care and Home Help cases
- Document review findings and communicate effectively with providers and beneficiaries regarding review determinations
Required qualifications
- Active, unrestricted Michigan Registered Nurse (RN) license
- 3-5 years of experience in utilization review and long-term care or LTSS
- Experience with Michigan Medicaid or state-based healthcare contracts preferred
- Strong knowledge of Medicare, Medicaid, and long-term care regulations
- Bachelor's degree in nursing preferred or equivalent experience considered
Complete Job Description
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