- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...to make an impact** **Required Qualifications** + Active enhanced Registered Nurse , (eNLC) license (RN) with no… more
- CVS Health (Lansing, MI)
- …both verbal and written **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care setting + Must have active ... current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and… more
- Sharecare (Lansing, MI)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Evolent (Lansing, MI)
- … Management Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- CVS Health (Lansing, MI)
- …You can have life-changing impact on our members, who are enrolled in Care Management and present with a wide range of complex health and social challenges. With ... exciting opportunity as we grow and expand our Care Management Programs to change lives in new markets across...nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN, the TOC Coach ensures the member experiences… more
- United Therapeutics (Lansing, MI)
- …years of PAH nursing experience, including ICU and critical care of PAH patients + Registered Nurse (RN) - State Licensure and/or Compact State Licensure RN - ... make a difference. The Regional Field Director, RNS Program Management serves as a director of all clinical field...Registered Nurse - State Licensure and/or Compact… more
- Humana (Lansing, MI)
- …+ Bachelor's degree in nursing or social work. + Unrestricted Michigan Licensed Registered Nurse (RN) or Licensed Social Worker (LSW). + 5+ years ... of clinical experience, to include a combination of Utilization Management Case Management , and Managed Care. + 2+ years of leadership experience. +… 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 ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...or Specialty Pharmacy. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- CVS Health (Lansing, MI)
- …day. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the development ... Qualifications** + Candidate must have active, current and unrestricted Registered Nurse (RN) Licensure in state of...years of managed care experience + 1+ years of utilization management experience + Ability to travel… more
- Trinity Health (Chelsea, MI)
- …Type:** Part time **Shift:** Rotating Shift **Description:** ** Registered Nurse ** **Case Manager** **Department:** Utilization Management **Location:** ... Trinity Health + Tuition Reimbursement **Position Purpose:** Exceptional opportunity for a Registered Nurse Case Manager to support our vision and serve… more
- Highmark Health (Lansing, MI)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse (RN) license + Delaware RN...is part of the compact **Preferred** + Certification in Utilization Management or a related field **SKILLS**… more
- McLaren Health Care (Lansing, MI)
- …of professional nursing experience providing broad clinical exposure. Current State of Michigan Registered Nurse license._ _ * _ _BLS certification as Healthcare ... Assists Manager of Patient Care Services with 24-hour accountability for the management of multiple patient care units/functions. In this capacity, will accomplish… more
- Trinity Health (Howell, 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
- McLaren Health Care (Lansing, MI)
- …complete BSN or BS within 3 to 5 years from date of hire.) + Licensed registered nurse in the State ofMichigan. + BLS certification as Healthcare Provider. + ... **Position Summary:** Has responsibility for 24-hour accountability for the management of assigned patient care unit(s)/function(s). In this capacity, will… more
- Baylor Scott & White Health (Lansing, MI)
- …Should have a minimum of (2) two years relevant work experience. + Hold a valid Registered Nurse license (RN) As a health care system committed to improving the ... - must reside in North Texas or Central Texas Regions!** **Setting: Case Management - Post Partum/Prenatal Experience is a MUST** **Schedule: FT Monday-Friday 8:30am… more