Michigan Licensed Utilization Review Nurse

Job Summary

A company is looking for a Utilization Review Nurse, LTSS and HCBS.

Key Responsibilities

• Conduct clinical reviews and authorizations for LTSS and HCBS services
• Collaborate with interdisciplinary teams to ensure continuity of care and monitor utilization patterns
• Document clinical decisions and stay current with federal and state regulations

Required Qualifications

• Active and unrestricted RN license in the state of Michigan
• 3+ years of clinical experience
• 1+ years of experience in LTSS, HCBS, or managed care
• Solid knowledge of Medicaid programs and HCBS waiver services
• Proficiency in clinical documentation systems and utilization management platforms