• 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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  • 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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  • Registered Nurse RN - Case Manager

    Trinity Health (Ann Arbor, MI)
    …Type:** Part time **Shift:** Day Shift **Description:** **POSITION PORPOSE** + 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 (06/11/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Ann Arbor, 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
    Molina Healthcare (06/11/25)
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  • Revenue Integrity - Nurse Auditor

    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 (06/12/25)
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  • Primary Care Nurse (Homecare)

    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 (05/01/25)
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  • Clinical Social Worker MSW

    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 (05/21/25)
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  • Ops-UM Training Specialist

    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
    Integra Partners (06/03/25)
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  • Supervisor, Clinical Documentation Integrity (CDI…

    Trinity Health (Livonia, MI)
    …Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse (RN) License + Registered Health Information Administrator ... as it relates to reimbursement and other clinical data quality management for colleague training. Provides quality and productivity monitoring; coordinates and… more
    Trinity Health (06/09/25)
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  • APP Manager, Surgical Specialties (Bariatric, ENT,…

    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
    Corewell Health (05/03/25)
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  • Care Manager

    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
    AmeriHealth Caritas (05/31/25)
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  • Care Review Clinician, PA (RN) - Transplant Team…

    Molina Healthcare (Ann Arbor, 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
    Molina Healthcare (06/06/25)
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  • NP/PA Thoracic and General Robotic

    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
    Trinity Health (03/27/25)
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  • Operative NP/PA - General Robotics and Ortho

    Trinity Health (Howell, MI)
    …Practitioner Program with emphasis on area of certification/licensure. **NP Licensure** : Current Registered Nurse and Nurse Practitioner license in the ... managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. In partnership with the supervising physician the NP/PA… more
    Trinity Health (06/11/25)
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  • Director Clinical Program - Cardiovascular…

    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 (06/05/25)
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  • RN Clinical Database Specialist

    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
    Corewell Health (05/06/25)
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  • Field Educator

    Hospice of Michigan (Ann Arbor, 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
    Hospice of Michigan (04/16/25)
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  • Unit Clerk- 4 West- St. Mary Mercy

    Trinity Health (Livonia, MI)
    … and trouble shooting + Makes a manual requisition for patient orders for Registered Nurse approval during emergencies, codes and downtime. + Maintains unit ... error report(s) or upon request. + Refer to the Department Charge Management Manual for authoritative and department specific processes and timelines. **JOB… more
    Trinity Health (06/13/25)
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