- 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 ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… 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
- R1 RCM (Detroit, MI)
- …in your state of residence + At least 2 years of recent hospital-based Utilization or Case Management Experience is preferred + At least 3 years of clinical ... of the evidence-based criteria. The successful candidate will have hospital-based Utilization Review or Case Management experience. **Responsibilities:** +… more
- Ascension Health (Detroit, MI)
- …staff committee. **Requirements** Licensure / Certification / Registration: + Practical/Vocational Nurse credentialed from the Michigan Board of Nursing preferred. + ... Registered Nurse credentialed from the Michigan Board of Nursing preferred....Health Info Tech credentialed from the American Health Information Management Association (AHIMA) preferred. Education: + High School diploma… more
- McLaren Health Care (Mount Clemens, MI)
- …barriers to D/C).4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers.5. ... and maintenance of continuing education requirements **Preferred:** * Experience in utilization management /case management , critical care, or patient… more
- Trinity Health (Pontiac, MI)
- …to providing comfort, relieving pain, and alleviating anxiety. 3 Conducts a utilization management assessment on a visit basis to facilitate appropriate ... School of Nursing or equivalent. **B.** **Licensure / Certification** Oncology Certified Nurse (OCN), preferred. Current licensure to practice nursing in the State… more
- Tenet Healthcare (Detroit, MI)
- …“match” rate to ensure improvement in the accurate application of InterQual criteria Utilization Management § Implements and monitors processes to ensure medical ... support. 8. Technical knowledge of community resources, regulatory requirements, reimbursements and utilization management procedures in order to function as a… more
- Corewell Health (Royal Oak, MI)
- …1. Identifies patients that need care management services (ie utilization review; care coordination; and/or discharge/transition planning). 2 . Responsible ... Recognized by US News & World Report as the # 2 hospital in Michigan and one of the top...and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning,… 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...pursuing a bachelor's degree in nursing with completion within 2 years of hire. + 2 years… 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...pursuing a bachelor's degree in nursing with completion within 2 years of hire. + 2 years… more
- Tenet Healthcare (Detroit, MI)
- … experience preferred. 3. At least 2 years of acute hospital case management experience. 4. Registered Nurse or LCSW/LMSW license; or relevant experience as ... for Case Management scope of services, including utilization management supporting medical necessity and denial...and/or healthcare administration, health science or related discipline preferred. 2 . A minimum of 5 years of experience in… more
- CTTX Health (Detroit, MI)
- …of national standards for Case Management scope of services, including utilization management supporting medical necessity and denial prevention, transition ... case management leadership experience preferred. Business planning and project management experience preferred. 3. Registered Nurse or LCSW/LMSW license; or… more
- Tenet Healthcare (Detroit, MI)
- …national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention. Transition ... underutilization, q) and other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management : Balances clinical and financial requirements and… more
- Corewell Health (Grosse Pointe, MI)
- …of care and cost effectiveness through the integration and functions of utilization management , and/or care coordination, discharge planning, and appropriate ... for groups of patients as it relates to disease management , resource utilization , access, discharge planning, quality,...pursuing a bachelor's degree in nursing with completion within 2 years of hire. + 2 years… more
- Trinity Health (Farmington Hills, MI)
- …of nursing plus at least four (4) years of nursing experience, to include two ( 2 ) years of utilization review/case management , managed care or comparable ... **MINIMUM QUALIFICATIONS** Must possess a demonstrated knowledge of denial management functions. Registered Nurse and a graduate...and managed care. Knowledge of and experience in case management and utilization management . Knowledge… more
- Corewell Health (Royal Oak, MI)
- …and Holidays. About Royal Oak Hospital Recognized by US News & World Report as the # 2 hospital in Michigan and one of the top hospitals in the country. It is a ... excellence for staff recruitment and retention and clinical and business outcomes. The Nurse Manager is responsible to ensure safe and effective delivery of patient… more
- Trinity Health (Livonia, MI)
- …Required.** Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/ management /discharge planning or ... Join our Remarkable Care Team as a** **Case Manager** **in the Case Management Department awaits YOU ** **SHIFT-** **Flexibility- Would require some weekends,… more
- Tenet Healthcare (Detroit, MI)
- …Brain Injury FT Nights Sign-on Bonus Available - 2406001410 Description : The Registered Nurse (RN) is a member of the Patient Care Services Team. The Registered ... Nurse is responsible for the satisfactory completion of nursing...clinical pathways. The RN reports directly to senior unit management , participates in shared decision-making activities and establishes relationships… more
- Tenet Healthcare (Detroit, MI)
- …BSN within two years; or, eight or more years of current equivalent clinical experience. 2 . Licensed to practice as a Registered Nurse (RN) in the state of ... of Excellence. Job Summary Under the supervision of designated management and in collaboration with support staff (eg, clinical... and in collaboration with support staff (eg, clinical nurse specialists and nurse educators), plan, implements… more
- McLaren Health Care (Mount Clemens, MI)
- …performance and/or leadership of patient care team members and patient care management staff. Assists in the coordination of patient care through the appropriate ... utilization of all resources; staff, equipment, supplies, etc. **Essential...assigned unit/units in collaboration with the assigned clinical manager. 2 . Promotes collaboration regarding patient care issues with various… more