- McLaren Health Care (Port Huron, MI)
- …as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate ... for timeliness, appropriateness and completeness as pertains to the utilization management process including level of care,...and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse (RN) ⦁ Bachelor's degree in… more
- Cognizant (Lansing, MI)
- …- Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- 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
- 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...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- CVS Health (Lansing, MI)
- … solutions that promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant, where you'll ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse (RN) - Case Manager - 2506003285 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... 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
- McLaren Health Care (Pontiac, MI)
- …barriers to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. ... and directed. #LI-AK1 _Required_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in...the Military Training network (MTN) _Preferred:_ + Experience in utilization management /case management , critical care,… 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
- Henry Ford Health System (Detroit, MI)
- The Certified Registered Nurse Anesthetist (CRNA) Manager is a Certified Registered Nurse Anesthetist who ensures the delivery of safe anesthetic patient ... activities in accordance with regulatory and accrediting organizations. . Hires certified registered nurse anesthetists for the department. Accepts input on… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE : University Hospital (9C Adult Psychiatry Unit) Apply Now **Job Summary** The Adult Inpatient Psychiatry Unit (9C) offers inpatient diagnostic ... emphasize coordinating these recommendations with ongoing or subsequent psychiatric management . Patients also may be invited to participate in...Eighteen (18) months of recent psych experience as a Registered Nurse NOTE: In order to be… more
- Veterans Affairs, Veterans Health Administration (Saginaw, MI)
- …For more information, refer to Required Documents below This job announcement is for a Registered Nurse - Patient Aligned Care Team at the Aleda E. Lutz VA ... and coaching on wellness, disease prevention, and chronic care management . Assist in directing the provision of nursing education,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Veterans Affairs, Veterans Health Administration (Iron Mountain, MI)
- …For more information, refer to Required Documents below. Responsibilities The Float Registered Nurse (RN) is responsible for providing competent, evidence-based ... equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion… more
- McLaren Health Care (Grand Blanc, MI)
- …role, responsibilities tools, and methodologies. _Required:_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in nursing from accredited ... maintenance of continuing education requirements Preferred: + Experience in utilization management /case management /clinical documentation. + Certification… more
- McLaren Health Care (Yale, MI)
- …barriers to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. ... Standard Operating Procedure (SOP). **Qualifications:** _Required_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in nursing from accredited… more
- ChenMed (Detroit, MI)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... and assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- Trinity Health (Ann Arbor, MI)
- …Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** + The Registered Nurse Case Manager assumes overall accountability for patients' ... leadership role in achieving desired clinical, financial and resource utilization outcomes. + This is achieved by coordinating care...through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …are honored to be a part of this incredible work. What Will You Do? As a Registered Nurse at Pine Rest, you'll be part of tight-knit team that believes in the ... in the teaching of persons' served families, and provides milieu management . Communicates with and educates persons' served families/significant others in… more
- Henry Ford Health System (Warren, 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
- Corewell Health (Grand Rapids, MI)
- …clinical nursing and or case management /managed care or related field Preferred + Registered Nurse (RN) - State of Michigan Upon Hire required + Basic Life ... hospital in the state of Michigan. Manage all components of referral management , admission waiting list, insurance prior authorizations, continuous stay reviews and… more
- Fresenius Medical Center (Lansing, MI)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures are followed. + Assists with implementing… more