- Molina Healthcare (Sterling Heights, MI)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for … more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse ( RN ) - Case Manager - 2506003285 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... medical necessity screening and submission for Physician Advisor review , b) care coordination, c) transition planning assessment and...management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- Humana (Canton, MI)
- …of 2** **years experience in health care and/or case management** + **Active Michigan Registered Nurse ( RN ) license with no disciplinary action** + **Must ... care and advocating for optimal member outcomes. + Will review , assess, and complete medical complexity attestations...your skills to make an impact** **Required Qualifications** + ** Registered Nurse , Nurse Practitioner, or… more
- Fresenius Medical Center (Madison Heights, MI)
- …AND SCOPE:** Functions as part of the hemodialysis health care team as a Staff Registered Nurse to ensure provision of quality patient care on a daily basis ... + Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab requisitions for… more
- Henry Ford Health System (Detroit, MI)
- The Certified Registered Nurse Anesthetist (CRNA) Manager is a Certified Registered Nurse Anesthetist who ensures the delivery of safe anesthetic patient ... activities in accordance with regulatory and accrediting organizations. . Hires certified registered nurse anesthetists for the department. Accepts input on… more
- Henry Ford Health System (Detroit, MI)
- …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... and Skills: + Strong clinical knowledge and understanding of medical literature and research methodology. + Familiarity with financial...work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
- CVS Health (Detroit, MI)
- …conversation. **Required Qualifications** + Minimum 3+ years clinical practical experience as a Registered Nurse + Must have active and unrestricted Michigan ... heart, each and every day. **Position Summary** **Case Manager RN ** WFH Flexible This role will be 25-50%% travel...Registered Nurse licensure + Must be willing and able to… more
- McLaren Health Care (Pontiac, MI)
- …other related duties as required and directed. #LI-AK1 _Required_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from accredited ... unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. Reviews current DRG/LOS identified… more
- CVS Health (Detroit, MI)
- …status and health needs based on key questions and conversation. **Required Qualifications** - Registered Nurse with active MI state license in good standing ... all with heart, each and every day. **Case Manager RN ** WFH Flexible **Position Summary** Help us elevate our...all case management activities with members to evaluate the medical needs of the member to facilitate the member's… more
- Elevance Health (Dearborn, MI)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
- Henry Ford Health System (Detroit, MI)
- …established research protocol are met and in compliance with the Institutional Review Board (IRB) and sponsor guidelines. Identifies and recruits' patients into ... + Must have a minimum of 5 years of RN research experience. + Experience managing the project IRB...+ Ability to effectively communicate with patients, families, and medical group personnel. Additional Information + Organization: Henry Ford… more
- AccentCare, Inc. (Madison Heights, MI)
- Overview Registered Nurse / RN Team Director , Hospice Location: Madison Heights, MI Position: Registered Nurse / RN Team Director Job ID: ... Find Your Passion and Purpose as a Full-Time Hospice Registered Nurse / RN Team...+ Three+ years' experience in hospice, home health, general medical surgery, oncology, or patient population-specific nursing (ie, geriatrics,… more
- Molina Healthcare (Sterling Heights, MI)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...specific programs supported by the plan such as utilization review , medical claims review , long-term… more
- BioLife Plasma Services (Ypsilanti, MI)
- …requirements Currently licensed or certified in the state where responsibilities will be assigned: Registered Nurse ( RN ), Nurse Practitioner (NP) or ... the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to...eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of… more
- Molina Healthcare (Sterling Heights, MI)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Sterling Heights, MI)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- Molina Healthcare (Sterling Heights, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours:… more
- Molina Healthcare (Sterling Heights, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent… more
- Molina Healthcare (Sterling Heights, MI)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Sterling Heights, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more