• Registered Nurse Utilization

    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
    McLaren Health Care (05/07/25)
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  • Registered Nurse (Michigan Visiting…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE (Michigan Visiting Nurses) Apply Now **Mission Statement** Michigan Medicine improves the health of patients, populations and communities ... inclusion in the medical record. + Provides effective case management of assigned patients including the utilization ...this position **Desired Qualifications Home care experience as a Registered Nurse within the last two years… more
    University of Michigan (07/02/25)
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  • Complex Care - Registered Nurse Case…

    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
    Henry Ford Health System (05/20/25)
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  • Registered Nurse

    Veterans Affairs, Veterans Health Administration (Detroit, MI)
    Summary The Oncology/Hematology Registered Nurse is a clinical expert who uses advanced specialized knowledge and judgement for delivery of high quality and ... Responsibilities Preferred Experience: Chemotherapy Certification preferred. Duties: The Oncology/Hematology Registered Nurse Assesses, plans, implements, and evaluates… more
    Veterans Affairs, Veterans Health Administration (07/03/25)
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  • Registered Nurse RN - Case Manager

    Trinity Health (Ann Arbor, MI)
    …Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** + The Registered Nurse Case Manager assumes overall accountability for patients' ... leadership role in achieving desired clinical, financial and resource utilization outcomes. + This is achieved by coordinating care...through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for… more
    Trinity Health (06/24/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Romulus, MI)
    …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
    Fresenius Medical Center (06/28/25)
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  • Diabetes Educator and Research Nurse

    Wayne State University (Detroit, MI)
    …Bachelor's degree Experience Experienced (minimum 2 years of job-related experience) Current Registered Nurse (RN) licensure with the State of Michigan is ... Diabetes Educator and Research Nurse - Internal Medicine Wayne State University is...nutrition, mediation, fitness, sleep, dentition, and stress contexts, including management and monitoring. Coordinate the development, utilization ,… more
    Wayne State University (06/09/25)
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  • Home Health Nurse (Full-Time) POD 2…

    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
    Trinity Health (07/01/25)
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  • Primary Care Nurse - Homecare

    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
    Trinity Health (04/23/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Detroit, MI)
    …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review. + Minimum two years of experience in… more
    Molina Healthcare (07/03/25)
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  • Group Director of Case Management

    Tenet Healthcare (Detroit, MI)
    …hospital case management leadership experience, business planning and project management experience preferred. Required: Registered Nurse or LCSW/LMSW ... individual in this position has overall responsibility for hospital utilization management , transition management and...license. Must be currently licensed, certified, or registered to practice profession as required by law or… more
    Tenet Healthcare (05/07/25)
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  • Supervisor, Care Review (RN)

    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 Supervisor to ... manage a utilization management team supporting 14 Marketplace plans....skills. **Required License, Certification, Association** + Active, unrestricted State Registered Nursing (RN) in good standing. + Must have… more
    Molina Healthcare (07/09/25)
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  • Clinical Social Worker MSW

    Corewell Health (Wayne, 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
    Corewell Health (06/23/25)
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  • Ops-UM Training Specialist

    Integra Partners (Troy, MI)
    …Training & Development team as an Operations UM Training Specialist, specializing in Utilization Management (UM) processes. The ideal candidate will have a ... industry standards, regulatory requirements, and best practices in clinical documentation and utilization management and update training documents as required +… more
    Integra Partners (06/03/25)
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  • RN Bed Management

    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
    Corewell Health (06/14/25)
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  • RN Orthopedics Full Time Nights

    Tenet Healthcare (Detroit, MI)
    …standards of cardiac care for hospitals and physicians throughout the nation. SUMMARY The Registered Nurse (RN) is a member of the Patient Care Services Team. ... The Registered Nurse is responsible for the satisfactory...clinical pathways. The RN reports directly to senior unit management , participates in shared decision-making activities and establishes relationships… more
    Tenet Healthcare (06/26/25)
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  • Supervisor, Clinical Documentation Integrity (CDI…

    Trinity Health (Livonia, MI)
    …Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse (RN) License + Registered Health Information Administrator ... as it relates to reimbursement and other clinical data quality management for colleague training. Provides quality and productivity monitoring; coordinates and… more
    Trinity Health (06/09/25)
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  • APP Manager, Pediatrics

    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
    Corewell Health (05/28/25)
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  • Care Manager

    AmeriHealth Caritas (Southfield, MI)
    …in Nursing preferred. + 3+ years of clinical experience at the bedside (as a Registered Nurse ) working with medically fragile patients in an acute care, home ... **Licensure:** + Valid driver's license and car insurance. + Current and unrestricted Registered Nurse licensure. + Eligible to sit for Case Management more
    AmeriHealth Caritas (04/23/25)
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  • NP/PA Surgical Subspecialty - ENT, Urology,…

    Trinity Health (Ann Arbor, MI)
    …Practitioner Program with emphasis on area of certification/licensure. **NP Licensure** : Current Registered Nurse and Nurse Practitioner license in the ... managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. In partnership with the supervising physician the NP/PA… more
    Trinity Health (07/08/25)
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