RN Review Analyst | Remote | Detroit, MI | Contract

Registered Nurse – Review Analyst | Remote | Contract

Walker Healthforce is seeking a Registered Nurse – Review Analyst with 2–4 years of clinical experience to perform clinical utilization reviews, assess medical necessity, and evaluate appropriate levels of care across healthcare services. This is a Contract opportunity.

Start Date: ASAP

Location: Remote – Work from Home

Hours/Schedule: Monday-Friday, 40 hours

Worker Type: W2

Core Requirements:

• 2–4 years of clinical experience in acute patient care, discharge planning, case management, or utilization review.

• Current, unrestricted Michigan Registered Nurse (RN) license required.

• Demonstrated clinical knowledge of patient care and healthcare delivery processes.

• Ability to evaluate medical necessity, appropriate length of stay, intensity of services, and levels of care.

• Strong clinical assessment, analytical, and critical thinking skills.

We Consider It A Bonus If You Also Have:

• Bachelor's degree in nursing, allied health, business, or related field.

• One (1) year of experience in a health insurance plan or managed care environment.

• Certification in Case Management.

Job Responsibilities:

• Perform prospective, concurrent, and retrospective reviews of inpatient, outpatient, ambulatory, and ancillary healthcare services.

• Evaluate medical necessity and appropriateness of healthcare services.

• Assess length of stay, intensity of services, and levels of care.

• Review appeal requests initiated by healthcare providers, facilities, and members.

• Utilize clinical knowledge to support appropriate healthcare utilization decisions.

• Establish care plans and coordinate care across the healthcare continuum as needed.

• Conduct member outreach assessments when applicable.

What We Offer:

• Competitive compensation package

• Weekly pay via Direct Deposit

• Medical, Dental & Vision available

• 401k options

Why Work With Walker?

• Access to our top ranked team of recruiting and placement specialists

• Continuous, one-on-one support from a dedicated engagement manager

• Professional resume development and interview preparation

Contact our Recruiting Team today to experience the Walker Healthforce difference!

About Us:

Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we're custom not commodity and we've been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!

We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment.