- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor..., Licensed Vocational Nurse , or Licensed Practical Nurse license EXPERIENCE: + ... internal partners (eg, Provider Relations, Quality) to resolve escalations and address utilization management issues. + Represent UM nursing team in internal… more
- Integra Partners (Troy, MI)
- …other duties as assigned EDUCATION: Active, Licensed Vocational Nurse , or Licensed Practical Nurse license EXPERIENCE: + Minimum of 3 years of ... Integra is looking for a LPN /LVN experienced in the managed care payor environment...managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will… more
- Molina Healthcare (Warren, MI)
- …of relevant education and experience. + Licensed Vocational Nurse (LVN) or Licensed Practical Nurse ( LPN ). The license must be active and ... reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention. Transition ... Registered Nurse Case Manager (RN) - 2506003132 Description :...q) and other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management : Balances clinical and financial requirements… more
- Molina Healthcare (Warren, MI)
- …experience. * Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse ( LPN ), Advanced Practice Social Worker (APSW), ... years in one or more of the following areas: utilization management , care management , care...Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical… more
- Select Medical (Mount Clemens, MI)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse (RN/ LPN /LVN) or a Respiratory Therapist (RT)...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- Behavioral Center of Michigan (Detroit, MI)
- …and compiles records for the unit. Upholds system and organization in the nurse station, giving assistance to the assigned clinical staff in the unit. Performs ... for discharge/transfer. Makes appropriate copies for various departments (Nursing, Utilization Review, Billing, and Partial Hospitalization Program). + Collects… more