Clinical Review Coordinator Location: Southfield, MIDuration: 3-4 months Engagement Description: - Perform timely initial clinical review as well as provider appeals of select inpatient, outpatient, ambulatory and ancillary services requiring prior authorization. Demonstrate consistent ability to collect pertinent documentation and conduct medical services review applying appropriate criteria, which may include national standardized criteria, established client and client policy, benefit certificates and other resources as indicated, while at the same time utilizing sound nursing judgment.
Required Skills/Experience: - Two (2) to four (4) years of clinical experience which may include acute patient care, discharge planning, case management, and utilization review, etc.
- Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.
- Excellent written and verbal communication skills. Excellent customer service and interpersonal skills.
Education/Certifications – Include: - Registered Nurse with current unrestricted Michigan Registered Nurse license required.
- Bachelor’s degree in nursing, allied health, business, or related field preferred.
As an equal opportunity employer, ICONMA prides itself on creating an employment environment thatsupports and encourages the abilities of all persons regardless of race, color, gender,age, sexual,orientation, citizenship, or disability. •
Last updated on Feb 26, 2020