- 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 (Lapeer, MI)
- …barriers to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. ... is the point of contact. **Qualifications:** _Required_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in nursing from accredited educational… more
- Henry Ford Health System (Troy, 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
- Molina Healthcare (Sterling Heights, MI)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Corewell Health (Royal Oak, MI)
- …of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate ... managing a case load of patients that includes facilitating utilization management , and/or care coordination during the... review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan… more
- Corewell Health (Troy, MI)
- …of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate ... managing a case load of patients that includes facilitating utilization management , and/or care coordination during the... review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan… more
- Integra Partners (Troy, MI)
- …Training & Development team as an Operations UM Training Specialist, specializing in Utilization Management (UM) processes. The ideal candidate will have a ... industry standards, regulatory requirements, and best practices in clinical documentation and utilization management and update training documents as required +… more
- McLaren Health Care (Mount Clemens, MI)
- …_Required:_ + Bachelors degree in relevant field of healthcare + Current State of Michigan Registered Nurse license + Three years of prior work experience in a ... plans + Manage nursing payroll + Ensure schedules are balanced + Project management for nursing + Process improvement + Throughput **Direct reports** + House… more
- Corewell Health (Troy, MI)
- …required. Nurse Practitioner Candidate: + Current licensure to practice as a Registered Nurse and Nurse Practitioner specialty certification in the State ... you join our team at Corewell Health. Job Summary Responsible for the management of reporting APPs and APP supervisors including all activities related to direct… more
- AmeriHealth Caritas (Southfield, MI)
- …Nursing required. Bachelor of Science in Nursing preferred. + Current and unrestricted Registered Nurse licensure. + Knowledge and experience working with CSHCS ... is preferred. + 3+ years of clinical Pediatric experience at the bedside (as a Registered Nurse ) working with medically fragile patients in an acute care, home… more
- McLaren Health Care (Mount Clemens, MI)
- …Nursing * Current State of Michigan RN license * One year of experience as a Registered Nurse /Charge Nurse or Assistant Manager in Surgical Services, OR or ... performance and/or leadership of patient care team members and patient care management staff. Assists in the coordination of patient care through the appropriate… more
- Molina Healthcare (Sterling Heights, MI)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be… more
- Corewell Health (Southfield, MI)
- …in healthcare or related field + 2 years of relevant Nursing experience + LIC- Registered Nurse (RN) - State of Michigan upon hire Preferred + Bachelor's ... stakeholders. Also ensures continuity and coordination of services with appropriate utilization of resources. Responsible for stakeholder management across… more
- Hospice of Michigan (Southfield, MI)
- …Qualifications: + Bachelor of Science in Nursing preferred. Current State of Michigan Registered Nurse (RN) license in good standing is required. + Advanced ... practice. + Utilizes diverse teaching strategies to engage learners, including utilization of adult learning principles. + Demonstrates, maintains competency &… more