• 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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  • Registered Nurse Case Manager Full…

    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
    Tenet Healthcare (06/04/25)
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  • Complex Care - Registered Nurse Case…

    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
    Henry Ford Health System (05/20/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Romulus, 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
    Fresenius Medical Center (06/28/25)
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  • Diabetes Educator and Research Nurse

    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
    Wayne State University (06/09/25)
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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 (04/23/25)
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  • Group Director of Case Management

    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
    Tenet Healthcare (05/07/25)
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  • RN Care Coordinator

    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
    Corewell Health (06/27/25)
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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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  • RN Bed Management

    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
    Corewell Health (06/14/25)
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  • RN Orthopedics Full Time Nights

    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
    Tenet Healthcare (06/26/25)
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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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  • RN Transfer Center

    Corewell Health (Southfield, MI)
    …the course of each transfer or direct admission. Has sufficient knowledge about utilization management and internal hospital operation. + Promotes a network with ... long-term relationships. Qualifications + Required Associate's Degree Requires completion of a registered nurse program from an accredited school with an… more
    Corewell Health (06/23/25)
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  • APP Manager, Pediatrics

    Corewell Health (Royal Oak, 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 (05/28/25)
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  • Care Manager

    AmeriHealth Caritas (Southfield, MI)
    …in Nursing preferred. + 3+ years of clinical experience at the bedside (as a Registered Nurse ) working with medically fragile patients in an acute care, home ... **Licensure:** + Valid driver's license and car insurance. + Current and unrestricted Registered Nurse licensure. + Eligible to sit for Case Management more
    AmeriHealth Caritas (04/23/25)
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  • Care Review Clinician, PA (RN) Transplants

    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 (06/20/25)
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  • Assistant Manager, Surgical Services - McLaren…

    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
    McLaren Health Care (04/13/25)
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  • Manager, DRG Coding & Validation (RN) Remote

    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
    Molina Healthcare (06/14/25)
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  • Clinical Liaison Referral Services Full Time Days

    Tenet Healthcare (Detroit, MI)
    …experience with the targeted patient population preferred. 3. License to practice as a Registered Nurse in the State of Michigan. License to practice as a ... a working knowledge of the revenue cycle and resulting impact of utilization management decisions. 3. Interpersonal skills to work productively with all levels… more
    Tenet Healthcare (06/26/25)
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  • Maternal Program Coordinator Full Time Days

    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
    Tenet Healthcare (04/23/25)
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