Registered Nurse

Location: Remote (Must reside in Michigan) Position Type: Full-Time (40 hours/week) Pay Rate: $36.00 – $38.00 / hour Position Overview We are seeking a Registered Nurse (RN) to join a healthcare team supporting utilization review and clinical review activities for a Michigan health plan. This role evaluates medical services to ensure they meet medical necessity guidelines, appropriate levels of care, and established clinical criteria. The ideal candidate will have experience in utilization management within a health insurance plan or hospital setting . Nurses with strong, recent acute-care experience in the ICU, Emergency Room, or Medical-Surgical unit are also encouraged to apply if they meet the clinical experience requirements. This position is an excellent opportunity for a clinically experienced RN interested in applying nursing knowledge to healthcare reviews, care coordination, and clinical decision-making. Key Responsibilities Review medical records and service requests to evaluate medical necessity, level of care, and length of stay. Conduct prospective, concurrent, and retrospective clinical reviews. Review and document clinical findings, decisions, and appeals. Coordinate discharge planning and collaborate with providers and internal teams. Apply clinical guidelines and identify appropriate care alternatives when necessary. Required Qualifications Active, unrestricted Michigan RN license. Candidates must meet one of the following experience pathways: Experience in utilization review or utilization management within a health insurance plan or hospital setting. Pathway 2: Recent Acute-Care Experience 2 + years of recent, hands-on clinical nursing experience in an ICU, Emergency Room (ER), or Medical-Surgical unit. Strong clinical assessment, analytical, and documentation skills. Excellent written and verbal communication skills. Computer proficiency, including Microsoft Office and navigating multiple systems. Typing speed of at least 35 WPM. When you work at OpTech, not only do you get health and dental benefits, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. OpTech is an Equal Opportunity Employer (EOE), 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 vetera n. #J-18808-Ljbffr OpTech