- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Lansing, MI)
- …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- CVS Health (Lansing, MI)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- Sharecare (Lansing, MI)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- CVS Health (Lansing, MI)
- …we do it all with heart, each and every day. Drives effective utilization management practices by ensuring appropriate and cost-effective allocation of ... efficient use of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of… more
- CVS Health (Lansing, MI)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Evolent (Lansing, MI)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- CVS Health (Lansing, MI)
- …Tuesday 6:30am to 5pm in their respective time zone.** As a Care Management Associate you will be supporting comprehensive coordination of medical services including ... supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services.… more
- Sharecare (Lansing, MI)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- McLaren Health Care (Lansing, MI)
- Assists Manager of Patient Care Services with 24-hour accountability for the management of multiple patient care units/functions. In this capacity, will accomplish ... the mission and vision of McLaren Greater Lansing through effective utilization of all resources, constantly striving to increase quality patient care and maintain a… more
- McLaren Health Care (Lansing, MI)
- **Position Summary:** Has responsibility for 24-hour accountability for the management of assigned patient care unit(s)/function(s). In this capacity, will ... accomplish the mission and vision of McLaren Greater Lansing through effective utilization of all resources, constantly striving to increase quality patient care and… more
- Gentiva (Jackson, MI)
- …budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships ... team. This role is ideal for a licensed Registered Nurse (RN) with strong leadership experience in hospice care,...experience in hospice care, home health, or clinical operations management . If you're a natural leader who is passionate… more