- Molina Healthcare (Grand Rapids, MI)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for … more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …availability will be variable based on staffing needs. What Will You Do? As a Registered Nurse at Pine Rest, you'll be part of tight-knit team that believes ... ultimately help participants live in a more independent setting. RN Shifts available for pick up are 12 hours,...staff development. + Responsible for the utilization and continued review of patient care protocols, standards of practice, and… more
- Molina Healthcare (Grand Rapids, MI)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...specific programs supported by the plan such as utilization review , medical claims review , long-term… more
- BioLife Plasma Services (Grand Rapids, MI)
- …requirements Currently licensed or certified in the state where responsibilities will be assigned: Registered Nurse ( RN ), Nurse Practitioner (NP) or ... the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to...eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of… more
- Molina Healthcare (Grand Rapids, MI)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Grand Rapids, MI)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- Molina Healthcare (Grand Rapids, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours:… more
- Molina Healthcare (Grand Rapids, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent… more
- Molina Healthcare (Grand Rapids, MI)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Grand Rapids, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Grand Rapids, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
- CenterWell (Grand Rapids, MI)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... on-site at our** **Grand Rapids, MI** **branch location.** The ** RN Clinical Manager** coordinates and oversees all direct care...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …Pine Rest (https://www.pinerest.org/inpatient-services/services/older-adult-inpatient-services/) What Will You Do? As a Registered Nurse at Pine Rest, you'll be ... the healing power of your expertise and compassion. An RN is responsible and accountable to perform the nursing...staff development. + Responsible for the utilization and continued review of patient care protocols, standards of practice, and… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …Pine Rest (https://www.pinerest.org/addiction/treatments/inpatient-treatment-for-dual-diagnosis/) What Will You Do? As a Registered Nurse at Pine Rest, you'll be ... the healing power of your expertise and compassion. An RN is responsible and accountable to perform the nursing...staff development. + Responsible for the utilization and continued review of patient care protocols, standards of practice, and… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …workplace. Principal Duties and Responsibilities: + Works in collaboration with an unrestricted Registered Nurse to provide care to person's served in a dyad ... 90-180 days. What Will You Do? As a Graduate Nurse ( RN ) at Pine Rest, you'll be...compassionate care. + Responsible for the utilization and continued review of patient care protocols, standards of practice, and… more
- State of Michigan (Ionia, MI)
- …Friendly Employer here. Functions as staff nurse under the direction of a registered nurse supervisor. This position will provide support services to the ... Practical Nurse -Licensed E9 Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/4265575) Apply Practical ...medical service providers (MSP) and assist with clinic activities.… more
- Molina Healthcare (Grand Rapids, MI)
- …related field or equivalent experience, OR completion of any of the following programs: + Registered Nurse ( RN ) or State Licensed Vocational Nurse (LVN), ... in support of annual HEDIS project management and ongoing review of medical records submitted by providers....OR completion of any of the following programs: + Registered Nurse ( RN ) or State… more
- Fresenius Medical Center (Kentwood, MI)
- …appointments + Weigh patient and obtain vital signs + Collect treatment records and review for completion. Notify RN of incomplete / missing records. + Cleaning ... effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies procedures and training and in compliance… more
- Molina Healthcare (Grand Rapids, MI)
- …Microsoft Excel (edit/save spreadsheets, sort/filter) **Required License, Certification, Association** Licensed registered nurse ( RN ), Licensed practical ... CPT guidelines, internal policies, and contract requirements. This position completes a medical review to facilitate a referral to law enforcement or for payment… more
- Sedgwick (Grand Rapids, MI)
- …clinical review of referred claims; documents decision rationale; and completes medical review of all claims to ensure information substantiates disability. ... consult providers and employees; to provide case direction; and to ensure medical information substantiates the need for absence from work. **ESSENTIAL FUNCTIONS and… more