• Dental Network Service Representative

    Highmark Health (Lansing, MI)
    …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
    Highmark Health (11/14/25)
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  • Pharmacy Product Director - Medicare DSNP

    Highmark Health (Lansing, MI)
    …+ Participate in product specific Pharmacy and Therapeutics Committees and Drug Utilization Review (DUR) Committees as necessary or contractually required. + ... position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of...with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as… more
    Highmark Health (11/14/25)
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  • Psych RN, Inpatient Float

    Pine Rest Christian Mental Health Services (Grand Rapids, MI)
    …and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our ... a state-of-the-art psychiatric urgent care center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient, partial hospitalization (day… more
    Pine Rest Christian Mental Health Services (09/23/25)
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  • Psych RN, Geriatric Inpatient

    Pine Rest Christian Mental Health Services (Grand Rapids, MI)
    …and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our ... a state-of-the-art psychiatric urgent care center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient, partial hospitalization (day… more
    Pine Rest Christian Mental Health Services (11/08/25)
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  • Psych Graduate Nurse, At Risk Youth Residential

    Pine Rest Christian Mental Health Services (Grand Rapids, MI)
    …and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our ... a state-of-the-art psychiatric urgent care center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient, partial hospitalization (day… more
    Pine Rest Christian Mental Health Services (10/25/25)
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  • Medical Director-Dermatology Appeals

    Elevance Health (Dearborn, MI)
    …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... law. The **Medical Director-Dermatology Appeals** is responsible for the review of appeals for physical health medical...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
    Elevance Health (12/11/25)
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  • Associate Architect - Oracle PaaS Administrator

    Highmark Health (Lansing, MI)
    …effective application of appropriate design standards, methods, and tools. + Review application designs to ensure optimal technology selection, efficient resource ... utilization , and seamless system integration. + Ensure system architecture...automation scripts (Shell, Python) for streamlining tasks, ensuring peer review and version control. + Maintain comprehensive technical documentation,… more
    Highmark Health (12/02/25)
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  • PCO Medical Director- UM - Full Time

    CenterWell (Lansing, MI)
    …Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in an assigned ... review organization, such as Medicare Advantage,managedMedicaid, or Commercial health insurance. + Experience with national guidelines such as MCG(R) or… more
    CenterWell (11/06/25)
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  • Operations Management Executive Director

    Sevita (Detroit, MI)
    …documentation; maintain confidentiality and adherence to individual rights standards; review and respond accordingly to adverse action regulatory correspondence and ... protocol; manage timely incident reporting and response to higher-level incidents; review trends; work with state operations and quality improvement leadership to… more
    Sevita (11/12/25)
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  • Clinical Social Worker - Case Management

    Tenet Healthcare (Detroit, MI)
    …assessment and intervention for patients identified with identified needs including behavioral health , lack of support systems, financial barriers, end ... a continuum through effective resource coordination to help patients achieve optimal health , access to care and appropriate utilization of resources, balanced… more
    Tenet Healthcare (12/02/25)
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