Michigan Licensed UR/LTSS Nurse
Job Summary
Seeking a Michigan Licensed UR/LTSS Nurse, the contingent position offers remote work opportunities for experienced nurses to conduct 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 compliance with program requirements and clinical guidelines
- Conduct telephonic and virtual assessments for Nursing Facility Level of Care and Home Help quality reviews
- Document review findings and communicate effectively with providers and beneficiaries regarding determinations
Required qualifications
- Active, unrestricted Michigan Registered Nurse (RN) license
- Experience in Long-Term Care/LTSS and Utilization Review (UR) or Utilization Management (UM)
- 3-5 years of combined experience in utilization review and long-term care
- Bachelor's degree in nursing preferred or equivalent experience considered
- Strong knowledge of Medicaid regulations and long-term care guidelines
Complete Job Description
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