- Evolent (Lansing, MI)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Origami Brain Injury Rehabilitation Center (Mason, MI)
- …Unlock a fulfilling career as a member of Origami 's Leadership Team as the Clinical Nurse where you'll be at the forefront of residential client care, ... in developing program activities, guidelines, and identifying community resources. + Review external medical data, process prescriptions, and order medications.… more
- Humana (Lansing, MI)
- …Manager, Fraud and Waste Investigator: Nurse Audit/ Review performs clinical audit/validation processes to ensure that medical record documentation and ... approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to… more
- Fresenius Medical Center (Lansing, MI)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- Humana (Lansing, MI)
- …needs and by providing guidance along the healthcare continuum. You will perform clinical case review on members during an inpatient hospital admission. You ... us put health first** The NICU Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates...+ Bilingual is a plus - preferably Spanish + Clinical claim review experience **Additional Information** +… more
- CVS Health (Lansing, MI)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
- Highmark Health (Lansing, MI)
- …over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and ... utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical intervention for each member. The incumbent conducts… more
- CVS Health (Lansing, MI)
- …and implement innovative programs and initiatives to improve outcomes. + Manage medical record review and compile reports for both committee presentation ... and every day. **Position Summary** **Must live in Michigan** **Must hold a clinical license, preferably, Nursing License** The Manager of Health Care Quality will… more
- Cardinal Health (Lansing, MI)
- …to ensure a positive and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides ... manufacturers to rethink the reach and impact of their products. The Supervisor, Clinical Operations provides management and clinical oversight to a team of… more
- Fujifilm (Lansing, MI)
- **Position Overview** The Clinical Consultant, MI - I shall be responsible for providing clinical consulting for the project, report configuration (CV), workflow ... go-live support to Synapse PACS/MI projects. In addition, provide clinical support for sales and company team members with...HCUS team to gain customer acceptance of the FUJIFILM Medical Systems solution. + Participates in teaching and training… more
- Sedgwick (Lansing, MI)
- …need for absence from work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims; documents decision rationale; and ... Fortune Best Workplaces in Financial Services & Insurance Disability Clinical Specialist **PRIMARY PURPOSE** : To perform clinical...completes medical review of all claims to ensure… more
- Fresenius Medical Center (East Lansing, MI)
- …direct patient care staff on appropriate programs under the supervision of a nurse . + Provides developmental support to applicable clinical and facility staff. ... for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training...Related** + Participates in the recruitment process for new clinical staff + Assists with clinical orientation… more
- Zurich NA (Lansing, MI)
- Sr Supplier Medical Process Specialist 128416 Zurich North America is seeking am experienced Sr. Supplier Medical Process Specialist to join our team in one of ... commitment to work/life balance, and outstanding culture. As a Sr. Supplier Medical Process Specialist, you will manage supplier performance and work product in… more
- CVS Health (Lansing, MI)
- …and is knowledgeable in clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions ... it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit… more
- Michigan State University (East Lansing, MI)
- …GIM. The General Internist position will have a major role inpatient clinical services. Additional responsibilities of the qualified candidate will include teaching ... assignments. The GIM division represents one of the largest clinical units within the College of Human Medicine. We...programs, fellowship and CME teaching. We are committed to medical student education through all the four years of… more
- Michigan State University (East Lansing, MI)
- …to high-quality geriatric care focused on the whole individual. Faculty also teach medical students, residents, and fellows during their clinical rotations. The ... Faculty Appointment System. This unique position allows the candidate to combine clinical practice in geriatrics with teaching and/or research. The ideal candidate… more