- 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
- R1 RCM (Detroit, MI)
- …schedule of four ten-hour shifts Friday to Monday. **Required Skills:** + Active Registered Nurse (RN) license in your state of residence, with eligibility ... encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager Contingent Days - 2506001465 Description : DMC Harper University Hospital has distinguished itself in surgery and medicine and is ... 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
- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- Summary The Community Living Center (CLC) Registered Nurse (RN) assesses, plans, implements, and evaluates care based on age-specific components. Assumes ... members of the interdisciplinary team. Responsibilities The Community Living Center (CLC) Registered Nurse (RN) is responsible and accountable for individual… 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
- Tenet Healthcare (Detroit, MI)
- …Mgt. Leaders relating to Case Management scope of services, including utilization management , transition management promoting appropriate length of stay, ... and safe and timely patient throughput. Will integrate national standards for utilization management supporting medical necessity and denials prevention. … 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
- 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
- Hospice of Michigan (Southfield, MI)
- …CARE Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: + Registered Nurse with a baccalaureate degree in nursing, preferably a ... hospice & palliative care quality reporting, patient care, safety, risk management , infection control, outcomes and customer satisfaction. + Works collaboratively… more
- Molina Healthcare (Sterling Heights, MI)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review. + Minimum two years of experience in… more
- Henry Ford Health System (Troy, MI)
- REGISTERED NURSE CLIENT FOCUSED CASE MANAGER...in Case Management required. * Experience in Utilization Management preferred. * Experience in Health ... Registered Nurses to support our work in Case Management . In this role, you will support patients of...the need for healthcare services and drive improvements in utilization practices. + Conducts research across various platforms, including… 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
- Hospice of Michigan (Southfield, MI)
- …school of nursing with a current license to practice in State of Michigan as a Registered Nurse . Must have the ability to be licensed as a Registered ... business and patient care outcomes. Collaborates extensively with staff and management from multiple departments and organizations to achieve outcomes. + Assists… 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
- 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
- Henry Ford Health System (Detroit, MI)
- …chart in electronic medical record. Licenses Required + Current license to practice as a Registered Nurse in the State of Michigan, or obtain one within 90 days ... areas of the hospital + Coordinates intra-operative device assembly and management during device implant + Collaborates with anesthesia during all intra-operative… more