- 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
- Trinity Health (Ann Arbor, MI)
- …**Description:** **POSITION PURPOSE** + The Utilization Review Specialist is a Registered Nurse that is responsible for facilitating collection of patient ... clinical, age specific, developmental, cultural and spiritual needs. Facilitates utilization management documentation and appropriate communication with external… more
- R1 RCM (Detroit, MI)
- …schedule of four ten-hour shifts Friday to Monday. **Required Skills:** + Active Registered Nurse (RN) license in your state of residence, with eligibility ... encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager Contingent Days - 2506001465 Description : DMC Harper University Hospital has distinguished itself in surgery and medicine and is ... for case management scope of services including: Utilization Management supporting medical necessity and denial... experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- Summary The Community Living Center (CLC) Registered Nurse (RN) assesses, plans, implements, and evaluates care based on age-specific components. Assumes ... members of the interdisciplinary team. Responsibilities The Community Living Center (CLC) Registered Nurse (RN) is responsible and accountable for individual… 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
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE : University Hospital (Psychiatric Emergency Services) Apply Now **Job Summary** Provide clinical leadership in the nursing care of individuals, ... opportunities please contact Nurse Recruitment at ###. **Required Qualifications Active Registered Nurse licensure in the State of Michigan Two (2) years… more
- University of Michigan (Ann Arbor, MI)
- …Hospitalization Program) Apply Now **Job Summary** The Psychiatric Registered Nurse is responsible for initial assessments and management of physical, ... REGISTERED NURSE (Mott Childrens Hospital- Child...or other issues that may impact patient care. Provides utilization management by obtaining initial and continued… 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
- Henry Ford Health System (Troy, MI)
- …screening criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical ... required. + Bachelor of Science Nursing required OR four (4) years Case Management / Appeal/ Utilization Management experience in lieu of bachelor's degree.… 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
- 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
- University of Michigan (Ann Arbor, MI)
- …such as Allscripts + Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management ** + Conduct clinical review ... Allscript + Identify opportunities for cost reduction and participate in appropriate utilization management venues + Conducts referrals and consultation with… 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 ... Registered Nurses to support our work in Case Management . In this role, you will support patients of...the need for healthcare services and drive improvements in utilization practices. + Conducts research across various platforms, including… more
- Corewell Health (Farmington Hills, 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
- 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