- Amazon (Caledonia, MI)
- …site or through daily one-on-one interaction. Additionally, the OMR will participate in weekly case management review meetings as necessary. As an OMR, you will ... this position, you will work closely with the WHS Site Manager, WHS Specialist , and occasionally the Injury Prevention Specialist (IPS). This includes attending… more
- Amazon (Romulus, MI)
- …site or through daily one-on-one interaction. Additionally, the OMR will participate in weekly case management review meetings as necessary. As an OMR, you will ... this position, you will work closely with the WHS Site Manager, WHS Specialist , and occasionally the Injury Prevention Specialist (IPS). This includes attending… more
- Banner Health (MI)
- …accurate coding based on documentation for positive outcomes. 5. Performs ongoing audits/ review of inpatient and/or outpatient medical records to assure the use of ... Heath Risk Adjusted Factors, National Correct Coding Initiative (NCCI) and the effect on Case Mix Index by use of specialized software. 7. May code inpatient and… more
- Humana (Lansing, MI)
- …+ The RN Field Care Manager will be responsible for managing a case load and completing assessments with members in their home or community-based setting, ... to health care and advocating for optimal member outcomes. + Will review , assess, and complete medical complexity attestations and clinical oversights. + Ensures… more
- Evolent (Lansing, MI)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... delivery of high-value, evidence-based case reviews. Enjoy improved work-life balance while contributing to...the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
- University of Michigan (Ann Arbor, MI)
- …and UMH-West with all payers. MCCO also is responsible for Pre-Service Single Case Agreements, which are patient specific most often involving Out of State Payers. ... payer issues submitted through the SBAR process, serving as a strategic review point for determining the appropriateness of advancing concerns to Joint Operating… more
- Deloitte (Detroit, MI)
- …for you! Recruiting for this role ends on 01/31/2026. Work you'll do + Review and sign individual tax returns + Review tax equalization calculations and ... + Certified Equity Professional (CEP) + Certified Employee Benefits Specialist (CEBS) + Certified Pension Consultant (CPC) + Certified...are dependent on the facts and circumstances of each case . A reasonable estimate of the current range is… more
- Molina Healthcare (Ann Arbor, MI)
- …+ Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management ... the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, or other specific program… more
- University of Michigan (Ann Arbor, MI)
- …with students, trainees, faculty, and staff. + Partner with the Communication Specialist to review and update program-related content on the website ... emergent and urgent situations and make recommendations for solutions, case management, referral, and follow-up. + Identify risk factors...posted for a minimum of seven calendar days. The review and selection process may begin as early as… more
- Trinity Health (Livonia, MI)
- …as outlined in the CDI quality plan, such as by Clinical Documentation Specialist (CDS), service line, focus area and as otherwise necessary to ensure quality, ... compliance management as it relates to CDI. Assists with denials management, complex case resolution and may perform CDI reviews as directed. Provides CDS support… more