About this role

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

Source listing: virtualvocations_main