• RN Utilization Review

    Tenet Healthcare (Detroit, MI)
    RN Utilization Review Full Time Days - 2506001461 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...Conditions of Participation and Tenet policies Operates within the RN scope of practice as defined by state licensing… more
    Tenet Healthcare (07/03/25)
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  • Registered Nurse RN - Case…

    Trinity Health (Ann Arbor, MI)
    …weeks from 8 am to 5 pm Monday through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for conducting a focused assessment ... **Employment Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE**...and clinical risk issues and documentation completeness. + The RN Registered Nurse Case Manager… more
    Trinity Health (06/24/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Romulus, MI)
    …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
    Fresenius Medical Center (06/28/25)
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  • Registered Nurse Case Manager…

    Henry Ford Health System (Detroit, MI)
    …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... and the ability to work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a valid, unrestricted State of Michigan… more
    Henry Ford Health System (07/10/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire required ... patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2.… more
    Corewell Health (06/27/25)
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  • RN Case Manager

    Trinity Health (Chelsea, MI)
    …Part time **Shift:** Rotating Shift **Description:** ** Registered Nurse ** **Case Manager** **Department:** Utilization Management **Location:** Chelsea, ... + Tuition Reimbursement **Position Purpose:** Exceptional opportunity for a Registered Nurse Case Manager to support our...use of care plans, critical pathways, managed care, and utilization review processes and collaboration with all… more
    Trinity Health (06/04/25)
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  • RN Clinical Database Specialist

    Corewell Health (Southfield, MI)
    …Degree or equivalent in healthcare or related field + 2 years of Nursing experience + LIC- Registered Nurse ( RN ) - State of Michigan upon hire Preferred + ... requirements for meetings or events. We are seeking a highly skilled and detail-oriented RN Clinical Database Specialist to join our team with a primary focus on… more
    Corewell Health (07/02/25)
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  • RN Wound Care

    Corewell Health (St. Joseph, MI)
    …and other health professionals + Successful completion of competency based orientation program + LIC- Registered Nurse ( RN ) - STATE_MI State of Michigan Upon ... plan of care with the patient, consistent with changing needs and goals reflecting full scope of practice. + Collaborates in discharge planning for patient at time… more
    Corewell Health (06/19/25)
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  • RN Administrator Home Health

    Elara Caring (Ludington, MI)
    …Identifies and reports potential payment/coverage problems. + Supervises and coordinates utilization review activities. + Participates in strategic development ... Current State License as required by state or federal guidance + Licensed physician, registered nurse or holds an undergraduate degree + 3+ years healthcare… more
    Elara Caring (06/13/25)
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  • RN Case Manager

    Trinity Health (Muskegon, MI)
    …Unit** **Schedule: Full -time Day Shift** **Job Summary:** The **Care Coordinator RN ** is a licensed professional nurse who works collaboratively with ... **Employment Type:** Full time **Shift:** **Description:** **Job Title:** **Care Coordinator...communication, critical thinking, and interpersonal skills + Knowledge of utilization review , payer systems, and regulatory compliance… more
    Trinity Health (06/18/25)
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  • RN , Clinical Resource Coordinator

    Trinity Health (Livonia, MI)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** **POSITION SUMMARY:** Provides clinical support within Supply Chain Management for all aspects ... service activities for clinical departments. Responsible for identification of utilization and standardization opportunities resulting in supply spend savings and… more
    Trinity Health (07/02/25)
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  • Group Director of Case Management

    Tenet Healthcare (Detroit, MI)
    …goals and objectives that support overall strategic plans of the Case Management and Utilization Review strategy · Lead Group hospital Case Management and ... Utilization Review operations for cost-effective and clinically...experience, business planning and project management experience preferred. Required: Registered Nurse or LCSW/LMSW license. Must be… more
    Tenet Healthcare (05/07/25)
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  • Associate Manager - Duals Prior Authorization

    CVS Health (Lansing, MI)
    …the employee level **Required Qualifications** + Candidate must have active, current and unrestricted Registered Nurse ( RN ) Licensure in state of residence + ... Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the...**License** + Candidate must have active, current and unrestricted Registered Nurse ( RN ) Licensure in… more
    CVS Health (06/28/25)
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  • Ops-UM Training Specialist

    Integra Partners (Troy, MI)
    …to design individual training plans to help improve employee performance EDUCATION: + Registered Nurse ( RN ) certification from an accredited nursing program ... Integra Partners is seeking an experienced nurse educator to join our Operations Training &...to get things done. PREFERRED SKILLS: + Certification in Utilization Review or Case Management + Experience… more
    Integra Partners (06/03/25)
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  • Clinical Liaison Referral Services Full

    Tenet Healthcare (Detroit, MI)
    …care techniques and practices by participating in educational programs. Participation in Utilization Review committee process as needed. Maintains a working ... Clinical Liaison Referral Services Full Time Days - 2506001476 Description : DMC...patient population preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
    Tenet Healthcare (06/26/25)
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  • Endoscopy Nursing Supv

    Corewell Health (Grand Rapids, MI)
    …gained through 1+ year of related clinical experience in area of specialty Required + LIC- Registered Nurse ( RN ) - STATE_MI State of Michigan Upon Hire ... interpretation, performance improvement, performance correction, and coaching and mentoring.SHGR Nurse Supervisors are REQUIRED to obtain their Nursing Administration… more
    Corewell Health (06/13/25)
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  • Supervisor, Clinical Documentation Integrity (CDI…

    Trinity Health (Livonia, MI)
    …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... **Employment Type:** Full time **Shift:** **Description:** **Remote based work location**...to enhance clinical and coding skill sets and optimal utilization of the 3M CDI software. Responsible for scheduling… more
    Trinity Health (06/09/25)
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  • Job Posting Title NP/PA Surgical Subspecialty…

    Trinity Health (Ann Arbor, MI)
    …managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. In partnership with the supervising physician the ... **Employment Type:** Full time **Shift:** Night Shift **Description:** **Position Purpose**...emphasis on area of certification/licensure. **NP Licensure** : Current Registered Nurse and Nurse Practitioner… more
    Trinity Health (07/02/25)
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  • NP/PA Thoracic and General Robotic

    Trinity Health (Ann Arbor, MI)
    …managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. In partnership with the supervising physician, the ... **Employment Type:** Full time **Shift:** **Description:** The Thoracic & General...emphasis on area of certification/licensure. **NP Licensure** : Current Registered Nurse and Acute Care Nurse more
    Trinity Health (06/25/25)
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  • APP Manager, Pediatrics

    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 ... and implementation performance evaluations, OPPE/FPPE, etc. Represents APPs to outside review services such as Joint Commission, American College of Surgeons etc.… more
    Corewell Health (05/28/25)
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