- McLaren Health Care (Pontiac, MI)
- …12. Performs other duties as assigned. #LI-KH1 _Required_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in nursing from accredited educational ... requirements _Preferred:_ + Bachelor's degree in nursing + Experience in utilization management /case management /clinical documentation, critical care, or… more
- Henry Ford Health System (Detroit, MI)
- …and the ability to work in a fast-paced environment. Licenses and Certifications: + Registered Nurse (RN) with a valid, unrestricted State of Michigan license. + ... Proficiency with computers, electronic health records (EHR), database systems, and utilization review/case management documentation systems. + Knowledge of CMS,… more
- McLaren Health Care (Detroit, MI)
- …barriers to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. ... agencies per Standard Operating Procedure (SOP). **Required** * State licensure as a Registered Nurse (RN) * Bachelor's degree in nursing from accredited… more
- Molina Healthcare (Detroit, MI)
- **JOB DESCRIPTION** For this position we are seeking a (RN) Registered Nurse who be licensed in the state they reside. We are looking for a RN Manager to manage ... a utilization management team supporting 14 Marketplace plans....identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed… more
- Tenet Healthcare (Detroit, MI)
- …Mgt. Leaders relating to Case Management scope of services, including utilization management , transition management promoting appropriate length of stay, ... and safe and timely patient throughput. Will integrate national standards for utilization management supporting medical necessity and denials prevention. … more
- Molina Healthcare (Detroit, MI)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or ... in good standing Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (Detroit, MI)
- … Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse (RN) Program or a bachelor's degree in Nursing. **Preferred ... contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM… more
- Molina Healthcare (Detroit, MI)
- …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home,… more
- Molina Healthcare (Detroit, MI)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Sysco (Canton, MI)
- …application + Case Management in Workers' Compensation **Licenses/Certifications:** + Licensed Registered Nurse in State of Residence. License must be active ... fit for duty through injury prevention, employee wellness, case management , and process improvement that significantly impacts EHS's bottom-line...and unencumbered. + Licensed Registered Nurse in States within the area… more
- Trinity Health (Livonia, MI)
- …Qualifications:** + Graduate of an approved Nursing education program, BSN preferred. + Current Registered Nurse licensure in the state of practice. + Must have ... Aides and LPNs as needed. Provides therapeutic intervention, overall care management and achievement of top decile client outcomes and patient satisfaction.… more
- Hospice of Michigan (Southfield, MI)
- …CARE Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: + Registered Nurse with a baccalaureate degree in nursing, preferably a ... hospice & palliative care quality reporting, patient care, safety, risk management , infection control, outcomes and customer satisfaction. + Works collaboratively… more
- Henry Ford Health System (Troy, MI)
- REGISTERED NURSE CLIENT FOCUSED CASE MANAGER...in Case Management required. * Experience in Utilization Management preferred. * Experience in Health ... independently in a fast-paced environment. Dependent on volume, the Client Focused Case Management Nurse may also be responsible for handling case management… more
- Corewell Health (Royal Oak, MI)
- …of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate ... managing a case load of patients that includes facilitating utilization management , and/or care coordination during the... review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention. Transition ... and other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES : Utilization Management : Balances clinical and financial requirements... experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- Tenet Healthcare (Detroit, MI)
- …Work Education or Bachelor's degree in Business, Nursing or Health Care Administration. 2. Registered Nurse or LCSW / LMSW license. Must be currently licensed, ... Manager of Case Management RN or LMSW - 2406002577 Description :...patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and… more
- Corewell Health (Southfield, MI)
- …to inpatient adult, pediatrics and critical care, emergency and urgent care. Required + Registered Nurse (RN) - State of Michigan Upon Hire required How Corewell ... and transfers based on urgency of patient's condition and utilization of available beds. + Plan, prioritize and direct...use of EPIC applications as they pertain to Bed Management . + Delegate tasks as indicated for patient placement.… more
- Molina Healthcare (Detroit, MI)
- **JOB DESCRIPTION** For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside. Program Manager RN will be ... and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed...years in one or more of the following areas: utilization management , case management , care… more
- Hospice of Michigan (Southfield, MI)
- …school of nursing with a current license to practice in State of Michigan as a Registered Nurse . Must have the ability to be licensed as a Registered ... business and patient care outcomes. Collaborates extensively with staff and management from multiple departments and organizations to achieve outcomes. + Assists… more
- Corewell Health (Royal Oak, MI)
- …required. Nurse Practitioner Candidate: + Current licensure to practice as a Registered Nurse and Nurse Practitioner specialty certification in the State ... you join our team at Corewell Health. Job Summary Responsible for the management of reporting APPs and APP supervisors including all activities related to direct… more