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Medical Review Rn Jobs in Michigan (NOW HIRING)

Bestica Healthcare

RN - Utilization Review

Lansing, MI · On-site

Utilization Review Rn Travel Position We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative.

OpTech LLC

Registered Nurse-Review Analyst

Detroit, MI · On-site

Detroit, Michigan Registered Nurse (RN) Contract Job Title : RN Review Analyst: Location: Michigan ... Contact appropriate medical and support personnel to identify and recommend alternative treatment ...

OpTech

Registered Nurse-Review Analyst

Detroit, MI · On-site

Detroit, Michigan Registered Nurse (RN) Contract Job Title : RN Review Analyst: Location: SE ... Contact appropriate medical and support personnel to identify and recommend alternative treatment ...

OpTech LLC

Registered Nurse-Review Analyst

Detroit, MI · On-site

Detroit, Michigan Registered Nurse (RN) Contract Job Title : RN Review Analyst: Location: SE ... Contact appropriate medical and support personnel to identify and recommend alternative treatment ...

EPITEC

Registered Nurse-Review Analys

Detroit, MI · On-site

$34 - $38/hr

Job #104611 Review Analyst RN 100% Remote in Michigan Rate: $34-$38/hour SUMMARY Perform ... Contact appropriate medical and support personnel to identify and recommend alternative treatment ...

G-TECH Services

Be Seen First

RN-Clinical Review Analyst

Detroit, MI · On-site

$33 - $34/hr

... RN license. You will perform prospective, concurrent and retrospective review of inpatient ... Clinical experience in ICU, ER, or medical surgical unit preferred * Prefer utilization management ...

Kyyba

Registered Nurse-Review Analyst

Detroit, MI · On-site

Job Title: ( Registered Nurse-Review Analyst ) About Kyyba: Founded in 1998 and headquartered in ... Contact appropriate medical and support personnel to identify and recommend alternative treatment ...

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Medical Review Rn information

What is a Medical Review RN?

A Medical Review RN is a registered nurse who specializes in reviewing medical records and claims to ensure they meet established guidelines and standards. These nurses often work for insurance companies, government agencies, or healthcare organizations, evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. Their role may include determining medical necessity, performing utilization reviews, and supporting appeals or audits. They use their clinical knowledge to interpret complex medical information and collaborate with healthcare providers to support accurate decision-making.

Can I make $500,000 as a nurse?

Medical Review RNs typically do not earn $500,000 annually, as most nursing salaries are below that level. High earnings in nursing usually require advanced roles, specialized certifications, management positions, or work in high-paying industries or locations. Achieving such a salary may involve additional education, experience, and responsibilities beyond standard nursing roles.

What does a medical review RN do?

A Medical Review RN evaluates insurance claims, medical records, and provider documentation to determine coverage and compliance with policies. They ensure accurate assessment of medical necessity, often working with healthcare providers and insurance companies, and may require knowledge of medical coding and documentation standards.

How to make $300,000 as a nurse?

Medical Review RNs can increase their earnings by gaining specialized certifications, such as in case management or legal nurse consulting, and working in high-demand settings like telehealth or insurance companies. Advancing to senior or managerial roles, working overtime, or taking on consulting projects can also boost income toward $300,000 annually.

How does a Medical Review RN collaborate with other healthcare professionals during the review process?

A Medical Review RN often works closely with physicians, case managers, and insurance representatives to ensure that medical claims and treatment plans meet regulatory and clinical guidelines. Collaboration may involve participating in interdisciplinary meetings, discussing complex cases, and providing clinical expertise to support utilization management decisions. Effective communication and teamwork are essential, as you'll need to relay findings, request additional information, and sometimes clarify medical necessity with providers. This collaborative environment helps ensure quality care for patients while maintaining compliance with payer policies.

How to make an extra 2000 a month as a nurse?

Medical Review RNs can increase their income by taking on additional freelance or per diem review assignments, working overtime, or obtaining specialized certifications to qualify for higher-paying roles. Developing expertise in specific medical areas or coding can also lead to higher-paying opportunities outside regular hours.

What are the key skills and qualifications needed to thrive as a Medical Review RN, and why are they important?

To thrive as a Medical Review RN, you need a strong clinical background, critical thinking skills, and an active RN license, often supported by experience in case management or utilization review. Familiarity with medical coding, claims management software, and knowledge of regulatory guidelines such as Medicare and Medicaid are typically required. Strong attention to detail, excellent written communication, and the ability to work independently are essential soft skills for this role. These competencies ensure accurate and compliant medical record reviews, which are critical for proper claims adjudication and regulatory adherence.
What cities in Michigan are hiring for Medical Review Rn jobs? Cities in Michigan with the most Medical Review Rn job openings:
Medical Review Rn jobs near you

RN - Utilization Review

Bestica Healthcare

Lansing, MI • On-site

Other

Posted 7 days ago

Job description

Utilization Review Rn Travel Position

We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative. We foster a positive culture, where innovation and synergy are encouraged to build our workplace into a community of like-minded, passionate people. Bestica is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. If this opportunity aligns with your capabilities and career desires, please take a moment to visit our website at www.besticahealthcare.com.

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