- McLaren Health Care (Detroit, MI)
- **Department: Utilization Management ** **Daily Work Times: 7:00am-3:30pm** **Shift: Days** **Scheduled Bi-Weekly Hours: 40** **Position Summary:** Responsible ... Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure...projects as needed. _Required:_ + State licensure as a registered nurse (RN) + Bachelor's degree in… more
- Universal Health Services (Dearborn, MI)
- Responsibilities Utilization Management Case Manager Beaumont Behavioral Health (a UHS Facility) A growing 144-bed behavioral health facility - Beaumont ... For more information, please visit our website: https://beaumontbh.com/ PositionSummary The Utilization Management Case Manager is primarily responsible for… more
- Henry Ford Health System (Detroit, MI)
- …while working in a fun and dynamic environment? Join our team as a Registered Nurse (RN) Case Manager! Who We're Looking For: Passionate, compassionate, and ... **NEWLY ENHANCED PAY RATES** Inpatient Case Management Days (8am to 4:30pm); Every 5th Weekend...new dyad Social Work/RN Case Manager model and remote utilization review setup, allowing you to excel in your… 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
- 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
- Fresenius Medical Center (Detroit, 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
- ChenMed (Detroit, MI)
- …RN with bachelor's degree in a related clinical field preferred. + A valid, active Registered Nurse (RN) license in State of employment required. + A minimum of ... people to join our team. * The Acute Care Nurse is responsible for achieving positive patient outcomes, managing...experience required. + A minimum of 1 year of utilization review and/or case management , home health,… more
- Ciena Healthcare (Novi, MI)
- …hard-working team that values communication and strong teamwork abilities. Responsibilities: The Care Management Nurse , MDS Nurse works the RAI process and ... PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management...Association of Nursing Assessment Coordinators (AANAC) requirements. Qualifications: + Registered Nurse , RN or Licensed Practical … 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. ... on Certification of Physician Assistants (NCCPA) OR master's prepared Advanced Practice Registered Nurse with NP board certification in their chosen specialty.… more
- Wayne State University (Detroit, MI)
- …Bachelor's degree Experience Experienced (minimum 2 years of job-related experience) Current Registered Nurse (RN) licensure with the State of Michigan is ... Diabetes Educator and Research Nurse - Internal Medicine Wayne State University is...nutrition, mediation, fitness, sleep, dentition, and stress contexts, including management and monitoring. Coordinate the development, utilization ,… more
- Corewell Health (Wayne, 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 (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
- CTTX Health (Detroit, MI)
- …hospital case management leadership experience preferred. Business planning and project management experience preferred. 3. Registered Nurse or LCSW/LMSW ... of national standards for Case Management scope of services, including utilization management supporting medical necessity and denial prevention, transition … more
- Tenet Healthcare (Detroit, MI)
- … management experience preferred. 3. At least 2 years of acute hospital case management experience. 4. Registered Nurse or LCSW/LMSW license; or relevant ... of national standards for Case Management scope of services, including utilization management supporting medical necessity and denial prevention, transition … more
- Trinity Health (Farmington Hills, MI)
- …professional behavior. **MINIMUM QUALIFICATIONS** Must possess a demonstrated knowledge of denial management functions. Registered Nurse and a graduate of ... financing and managed care. Knowledge of and experience in case management and utilization management . Knowledge of insurance and governmental programs,… more
- Tenet Healthcare (Detroit, MI)
- …standards of cardiac care for hospitals and physicians throughout the nation. SUMMARY The Registered Nurse (RN) is a member of the Patient Care Services Team. ... The Registered Nurse is responsible for the satisfactory...clinical pathways. The RN reports directly to senior unit management , participates in shared decision-making activities and establishes relationships… more
- Trinity Health (Livonia, MI)
- …or the equivalent in experience. Must possess one of the below: + Current Registered Nurse (RN) License + Registered Health Information Administrator (RHIA) ... Health Ministries (HM) in their defined region and day-to-day management of the CDI programs. Works with Director, CDI...to enhance clinical and coding skill sets and optimal utilization of 3M CDI software. Analyzes data to determine… more
- Ciena Healthcare (Detroit, MI)
- …assessments and care plan coordination for guests. The MDS Coordinator supervises the Care Management Nurse , MDS Nurse . At Ciena Healthcare, we take care ... with American Association of Nursing Assessment Coordinators (AANAC) requirements. Qualifications + Registered Nurse (RN) licensure + AANC certification a plus.… more
- Corewell Health (Farmington Hills, MI)
- …previous nursing home experience. Preferred + Progressive supervisory experience. Required + LIC- Registered Nurse (RN) - STATE_MI State of Michigan required ... quality patient care is provided. Responsible for patient care management , human resource utilization , and the operational...their assigned shift. Essential Functions + Performs limited charge nurse duties. + Conducts rounds on a regular basis… more
- Tenet Healthcare (Detroit, MI)
- …or health care field, or equivalent combination of education and/or related experience. Registered Nurse preferred. 2. Two to three years progressively more ... established policies and procedures, monitors patient care for quality assurance, utilization review and risk management activities. Determines appropriateness… more