- 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
- Trinity Health (Ann Arbor, MI)
- …**Description:** **POSITION PURPOSE** + The Utilization Review Specialist is a Registered Nurse that is responsible for facilitating collection of patient ... clinical, age specific, developmental, cultural and spiritual needs. Facilitates utilization management documentation and appropriate communication with external… more
- Veterans Affairs, Veterans Health Administration (Ann Arbor, MI)
- …Preferred Experience: Primary Care Experience Patient Aligned Care Team (PACT) Experience Registered Nurse Care Management Experience Physical Requirements: ... S. Kettles VA Medical Center is seeking a Full-Time Registered Nurse (RN) assigned to a Patient...all elements of the nursing process through patient education, self- management , and customer satisfaction throughout the continuum of care.… more
- University of Michigan (Ann Arbor, MI)
- …data, educating patients on symptom management , triaging patient virtually. The Registered Nurse will also observe, interpret patient symptoms and report to ... REGISTERED NURSE (PACS- Patient Monitoring at... REGISTERED NURSE (PACS- Patient Monitoring at Home Program) Apply...PCP, Specialist and plan of care to reduce ED utilization and acute care hospitalizations + Monitor daily transmissions… 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
- Sysco (Canton, MI)
- …application + Case Management in Workers' Compensation **Licenses/Certifications:** + Licensed Registered Nurse in State of Residence. License must be active ... fit for duty through injury prevention, employee wellness, case management , and process improvement that significantly impacts EHS's bottom-line...and unencumbered. + Licensed Registered Nurse in States within the area… 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
- University of Michigan (Ann Arbor, MI)
- …such as Allscripts + Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management ** + Conduct clinical review ... Allscript + Identify opportunities for cost reduction and participate in appropriate utilization management venues + Conducts referrals and consultation with… 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
- 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 (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
- 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
- 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
- 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