- 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
- R1 RCM (Detroit, MI)
- …schedule of four ten-hour shifts Friday to Monday. **Required Skills:** + Active Registered Nurse (RN) license in your state of residence, with eligibility ... encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital… more
- 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
- 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
- Molina Healthcare (Detroit, 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
- Trinity Health (Ann Arbor, MI)
- …travelling between locations within the region. **MINIMUM QUALIFICATIONS** **Licensure/Certification:** Registered Nurse or Licensed Vocational Nurse / ... financing and managed care. Knowledge of and experience in case management and utilization management . Outpatient CDI experience preferred. Knowledge of… more
- Trinity Health (Livonia, MI)
- …Qualifications:** + Graduate of an approved Nursing education program, BSN preferred. + Current Registered Nurse licensure in the state of practice. + Must have ... Aides and LPNs as needed. Provides therapeutic intervention, overall care management and achievement of top decile client outcomes and patient satisfaction.… more
- Tenet Healthcare (Detroit, MI)
- …hospital case management leadership experience, business planning and project management experience preferred. Required: Registered Nurse or LCSW/LMSW ... individual in this position has overall responsibility for hospital utilization management , transition management and...license. Must be currently licensed, certified, or registered to practice profession as required by law or… more
- Corewell Health (Farmington Hills, 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
- 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 ... 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
- Molina Healthcare (Detroit, 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
- Trinity Health (Ann Arbor, MI)
- …Practitioner Program with emphasis on area of certification/licensure. **NP Licensure** : Current Registered Nurse and Acute Care Nurse Practitioner license ... managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. In partnership with the supervising physician the NP/PA… more
- Tenet Healthcare (Detroit, MI)
- …role REQUIRED CERTIFICATIONS/LICENSURE: Possession of current State License for Registered Nurse . PREFERRED CERTIFICATIONS/LICENSURE: Specialty or Administration ... care at the hospital where program manager services are provided. General Management : 1. Responsible for monitoring the provision of maternal services through all… more
- Henry Ford Health System (Southfield, MI)
- …policy. Minimum Qualifications: Licensure/Certification/Registration(One of the following required): + Registered Nurse (RN), or + Certified Radiologic ... system. This role is responsible for the strategic direction, fiscal management , operational efficiency, quality assurance, and regulatory compliance of all cardiac… more
- Henry Ford Health System (Detroit, MI)
- …on Certification of Physician Assistants (NCCPA) OR master's prepared Advanced Practice Registered Nurse with NP board certification in their chosen specialty. ... goal of increasing Henry Ford Health's participation. Professional Staff/Human Resources Management 1. Provides regular and timely communication among a defined… 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