• Clinical Auditor Registered Nurse

    Humana (Lansing, MI)
    …a part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... skills to make an impact** **Required Qualifications** + Active Registered Nurse license in a state that...one, (1), year of experience auditing and/or performing case management or utilization management chart… more
    Humana (06/26/25)
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  • Registered Nurse Utilization

    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
    McLaren Health Care (05/07/25)
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  • Utilization Management Nurse

    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
    CVS Health (06/30/25)
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  • RN Case Manager

    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
    Trinity Health (06/04/25)
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  • Case Manager Registered Nurse - Case…

    McLaren Health Care (Flint, MI)
    …resources, and cost of care. **Qualifications:** _Required:_ * Current Michigan licensure as Registered Nurse required. * BSN or Bachelor degree in health ... the care provided is safe, effective, efficient, client-centered, timely and equitable. Utilization of the Case Management process includes the achievement of… more
    McLaren Health Care (06/04/25)
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  • Registered Nurse Case Manager Full…

    Tenet Healthcare (Detroit, MI)
    Registered Nurse Case Manager Full Time Days - 2506001582 Description : DMC Sinai-Grace Hospital is DMC’s largest hospital, offering a comprehensive heart ... 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
    Tenet Healthcare (06/04/25)
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  • Utilization Management Clinician…

    CVS Health (Lansing, MI)
    …in the state of residence (LMSW, LCSW, LISW, LPC, or comparable) or Registered Nurse licensure with psychiatric specialty, certification, or experience in state ... Monday through Friday 8:30-5pm EST. No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral… more
    CVS Health (06/25/25)
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  • Registered Nurse (Michigan Visiting…

    University of Michigan (Ann Arbor, MI)
    REGISTERED NURSE (Michigan Visiting Nurses) Apply Now **Mission Statement** Michigan Medicine improves the health of patients, populations and communities ... inclusion in the medical record. + Provides effective case management of assigned patients including the utilization ...this position **Desired Qualifications Home care experience as a Registered Nurse within the last two years… more
    University of Michigan (06/28/25)
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  • Utilization Management Nursing

    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...+ Minimum of associate degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
    Humana (06/28/25)
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  • Registered Nurse - Community Care…

    Veterans Affairs, Veterans Health Administration (Ann Arbor, MI)
    Summary The LTC Charles S. Kettles VA Medical Center is seeking a Part-Time Registered Nurse Community Care Coordinator within Chief of Staff (COS) service. The ... decision making capacity. Possesses thorough knowledge of InterQual criteria, utilization management processes, clinical documentation requirements, current… more
    Veterans Affairs, Veterans Health Administration (06/28/25)
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  • Complex Care - Registered Nurse Case…

    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 (05/20/25)
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  • Registered Nurse , Afterhours 7 on/7…

    Gentiva (Traverse City, MI)
    …+ Good problem-solving skills + Good time management skills **We Offer** **As a Registered Nurse / RN, you will be eligible for:** + Competitive Pay + ... with them and other specialists to offer advanced illness management , a specialized form of high-touch palliative care designed...telephonic, video, and in person interventions afterhours. **As a Registered Nurse / RN, you will:** +… more
    Gentiva (04/15/25)
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  • Registered Nurse : University…

    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 (06/28/25)
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  • Registered Nurse - Community Care…

    Veterans Affairs, Veterans Health Administration (Ann Arbor, MI)
    …Community Based Outpatient Clinics (CBOCs). Responsibilities Job Duties for Community Care Registered Nurse Care Coordinator: Coordinate and facilitate care for ... interdisciplinary teams to develop and implement comprehensive care consult management for patients. Conduct thorough assessments of patient needs...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (06/26/25)
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  • Registered Nurse , Case Manager…

    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...using a keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (06/19/25)
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  • Case Manager Registered Nurse

    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...Pharmacy or Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (06/19/25)
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  • Registered Nurse -Care Manager…

    McLaren Health Care (Petoskey, 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
    McLaren Health Care (04/30/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Lansing, MI)
    …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting...disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations… more
    Sharecare (05/10/25)
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  • Registered Nurse RN - Case Manager

    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
    Trinity Health (06/24/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Romulus, MI)
    …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
    Fresenius Medical Center (06/28/25)
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