- 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
- 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 (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
- 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
- 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 (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
- 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 (Southfield, MI)
- …to inpatient adult, pediatrics and critical care, emergency and urgent care. Required + Registered Nurse (RN) - State of Michigan Upon Hire required How Corewell ... and transfers based on urgency of patient's condition and utilization of available beds. + Plan, prioritize and direct...use of EPIC applications as they pertain to Bed Management . + Delegate tasks as indicated for patient placement.… more
- 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
- 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)
- …in Nursing required. Bachelor of Science in Nursing preferred. + Current and unrestricted Registered Nurse licensure.; + 3+ years of clinical experience at the ... accurate documentation of Member interactions in ACFC electronic care management platforms where applicable. + Monitor appropriate utilization...bedside (as a Registered Nurse ) working with medically fragile patients… 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
- Molina Healthcare (Sterling Heights, MI)
- …Training & Education **Preferred License, Certification, Association** Active and unrestricted Registered Nurse (RN) license and Certified Coding Specialist ... for timely and accurate reimbursement and data collection. Candidates with previous management and DRG validation experience are highly preferred. Work hours: Monday… 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
- Molina Healthcare (Sterling Heights, MI)
- …3-5 years clinical practice with managed care, hospital nursing or utilization management experience **Preferred License, Certification, Association** Active, ... the work performance of the HCS-Central Programs staff. Consults with the Management of HCS-Central Programs to devise and implement corrective action as necessary… 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
- Molina Healthcare (Troy, MI)
- **JOB DESCRIPTION** _For this position we are seeking a (RN) Registered Nurse who lives in MICHIGAN and must be licensed for the state of MICHIGAN. We cannot ... Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… more